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Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
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[SIGNIFICANCE OF IgG4 IN IDIOPATHIC RETROPERITONEAL FIBROSIS]
Masaaki Sanda1, Naoto Kamiya1, Yuka Sugizaki1
1Department of Urology, Toho University Sakura Medical Center.
Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
|October 19, 2022
Summary
Idiopathic retroperitoneal fibrosis diagnosis and treatment can be guided by immunoglobulin G4 (IgG4) levels. Monitoring serum IgG4 may help assess disease activity and optimize steroid therapy in patients with IgG4-related conditions.
Area of Science:
- Nephrology
- Immunology
- Pathology
Context:
- Retroperitoneal fibrosis (RPF) is categorized into idiopathic and secondary types.
- Idiopathic RPF can overlap with IgG4-related disease (IgG4-RD), mimicking malignancies.
- Definitive diagnosis of IgG4-RD RPF requires pathological examination.
Purpose:
- To investigate the diagnostic and therapeutic significance of immunoglobulin G4 (IgG4) in idiopathic retroperitoneal fibrosis.
- To evaluate serum IgG4 levels and their changes during steroid therapy.
- To explore minimally invasive diagnostic approaches for RPF.
Summary:
- This study examined 14 idiopathic RPF cases, measuring serum IgG4 and assessing treatment responses.
- One patient was diagnosed with IgG4-RD RPF, and five were classified as possible IgG4-RD.
- Computed tomography-guided biopsy and serum IgG4 monitoring showed promise in diagnosis and treatment management.
Impact:
- Computed tomography-guided biopsy offers a less invasive alternative for diagnosing RPF in high-risk patients.
- Serum IgG4 level monitoring can guide steroid therapy adjustments and assess disease activity in IgG4-related RPF.
- Findings suggest a potential role for empiric steroid therapy and IgG4 monitoring in managing idiopathic RPF.
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