在诊断IgG4相关疾病的挑战和陷
Adrian C Bateman1, Emma L Culver2
1Department of Cellular Pathology, Southampton General Hospital, MP002, Level E, South Block, Tremona Road, Southampton SO16 6YD, UK.
Seminars in diagnostic pathology
|November 24, 2023
概括
免疫球蛋白G4相关疾病 (IgG4-RD) 是一种复杂的纤维炎症状况,使用临床,血清学,放射学和组织学数据进行诊断. 组织病理学对于诊断至关重要,但将IgG4-RD与模仿物区分开来需要仔细的临床病理学相关性.
科学领域:
- 病理学 病理学 病理学
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 免疫球蛋白G4相关疾病 (IgG4-RD) 是一种纤维炎症状况,具有特定的组织学特征,包括淋巴细胞炎症和IgG4阳性血细胞.
- 诊断通常依赖于临床,血清学,放射学和组织学发现的组合.
- IgG4-RD可以存在于单个器官或是多中心的,最近描述的疾病分布模式.
研究的目的:
- 审查组织学检查在诊断IgG4相关疾病 (IgG4-RD) 中的作用.
- 讨论诊断挑战,特别是当临床或组织学特征不典型时.
- 要突出模仿IgG4-RD的情况,并强调临床病理相关性的重要性.
主要方法:
- 审查组织学检查在IgG4-RD诊断中的作用.
- 讨论诊断困难和模仿器.
- 重点是将组织学发现与整体临床图像相结合.
主要成果:
- 组织学检查是诊断IgG4-RD的一个关键组成部分,通常需要高IgG4+/IgG+血细胞比率 (>40%).
- 由于异常呈现和组织学特征,诊断可能具有挑战性.
- 许多非新发性和新发性疾病可以模仿IgG4-RD,需要仔细的差异诊断.
结论:
- 准确诊断IgG4-RD需要仔细的临床病理相关性,特别是在复杂或非典型的情况下.
- 组织学解释必须在患者的整体临床表现中进行语境化.
- 对IgG4-RD模仿体的认识对于适当的患者管理至关重要.
相关概念视频
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
337
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
337
Transcytosis of IgG
2.8K
Transcytosis is the process in which molecules are internalized by endocytosis, transported across the cell, and released through exocytosis from the opposite end of the cell. Molecules such as insulin, immunoglobulins, and certain nutrients are transferred through the recycling endosomes by recycling and transcytosis.
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...
2.8K
Inflammatory Bowel Disease II: Crohn's Disease
256
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
256
Myasthenia Gravis: Diagnostic Tests
905
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
905
Chronic Bowel Disorders: Introduction
457
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
457
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
165
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
165


