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Updated: May 14, 2026

Experimental Approaches for Biochemical Analysis of Glial Fibrillary Acidic Protein and Its Disease-associated Variants
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Published on: November 28, 2025

IgG4-related Disease: 2013 Update.

Paul A Monach1

  • 1Vasculitis Center and Section of Rheumatology, Boston University School of Medicine, 72 East Concord Street, E-533, Boston, MA, 02118, USA, pmonach@bu.edu.

Current Treatment Options in Cardiovascular Medicine
|February 9, 2013
PubMed
Summary

This opinion statement recommends prompt immunosuppressive treatment for IgG4-related disease, especially with vascular involvement. Treatment involves prednisone, with azathioprine or rituximab used for relapses, and surgical consultation for large artery issues.

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Antibody Transfection into Neurons as a Tool to Study Disease Pathogenesis
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Published on: September 26, 2012

Area of Science:

  • Immunology
  • Rheumatology
  • Vascular Medicine

Background:

  • IgG4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect multiple organs.
  • Vascular involvement, particularly in large arteries, presents unique management challenges.

Purpose of the Study:

  • To outline a clinical approach for managing IgG4-related disease, focusing on immunosuppressive therapy and vascular considerations.
  • To provide a stepwise treatment strategy for IgG4-RD, including initial management, relapse protocols, and surgical referral guidelines.

Main Methods:

  • The proposed management strategy begins with prednisone at 40-60 mg/day, with a planned dose reduction over several weeks.
  • Relapse management involves adjusting prednisone dosage and taper, potentially adding azathioprine, and escalating to rituximab for subsequent relapses.
  • Early consultation with a vascular surgeon is advised for patients with large artery involvement.

Main Results:

  • A structured approach to immunosuppression can effectively manage IgG4-related disease.
  • Sequential use of prednisone, azathioprine, and rituximab provides a treatment escalation pathway.
  • Timely surgical consultation is crucial for patients with significant vascular complications.

Conclusions:

  • Prompt initiation of immunosuppressive therapy, particularly prednisone, is recommended for IgG4-related disease.
  • A tiered treatment approach using azathioprine and rituximab is effective for managing relapses.
  • Vascular involvement necessitates specialized surgical consultation and management planning.