Cerebral involvement in IgG4-related disease

Joshi, Deepak; Jäger, R; Hurel, Steven J.; Pereira, Stephen P.; Johnson, Gavin; Chapman, Michael H.; Fowler, Robert; Winstanley, Alison; Losseff, Nicholas; Webster, George

doi:10.7861/clinmedicine.15-2-130

Cited by 35 publications

(21 citation statements)

References 34 publications

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“…The pituitary lesions are usually hypointense on T2-weighted imaging and show homogeneous contrast enhancement on T1-weighted images [116–123]. Absence of pre-contrast T1 hyperintensity in the posterior pituitary gland may suggest central diabetes insipidus, although this requires confirmation through endocrinological workup [116].…”

Section: Diagnostic Approachmentioning

confidence: 99%

Neurological Manifestations of IgG4-Related Disease

Baptista

Casian

Gunawardena

et al. 2017

Curr Treat Options Neurol

106

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Opinion statementIgG4-related disease (IgG4-RD) is a multisystem inflammatory disorder. Early recognition of IgG4-RD is important to avoid permanent organ dysfunction and disability. Neurological involvement by IgG4-RD is relatively uncommon, but well recognised—hypertrophic pachymeningitis and hypophysitis are the most frequent manifestations. Although the nervous system may be involved in isolation, this more frequently occurs in conjunction with involvement of other systems. Elevated circulating levels of IgG4 are suggestive of the condition, but these are not pathognomonic and exclusion of other inflammatory disorders including vasculitis is required. Wherever possible, a tissue diagnosis should be established. The characteristic histopathological changes include a lymphoplasmacytoid infiltrate, storiform fibrosis and obliterative phlebitis. IgG4-RD typically responds well to treatment with glucocorticoids, although relapse is relatively common and treatment with a steroid-sparing agent or rituximab may be required. Improved understanding of the pathogenesis of IgG4-RD is likely to lead to the development of more specific disease treatments in the future.

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Section: Diagnostic Approachmentioning

confidence: 99%

Neurological Manifestations of IgG4-Related Disease

Baptista

Casian

Gunawardena

et al. 2017

Curr Treat Options Neurol

106

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“…• Поражения ЦНС, гипопитуитаризм, ассоцииро-ванный с IgG4-сопряженным повреждением ги-пофиза, наиболее частое проявление -пахиме-нингит [27].…”

Section: поражение других органов и тканейunclassified

Igg4-Related Disease: Condition of the Problem

Vasilenko¹,

Виноградов²,

Бурлакова³

2017

Arhivʺ vnutr. med.

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Физиологическая роль IgG4 еще не до конца изучена. Известно, что они, как и другие антитела, участвуют в инактивации и удалении из организма веществ, идентифицированных иммунной системой, как чужеродные антигены. Также IgG4 реализуют эффекторные механизмы: связывание со специализированными иммунными клетками, осуществляющими после такого взаимодействия фагоцитоз чужеродных аген-тов или уничтожение зараженных клеток организма за счет зависимой от антител цитотоксичности. Мнения относительно способности IgG4 активировать комплемент зачастую противоречивы. Повышение концентрации иммуноглобулинов данного подкласса может свиде-тельствовать не только о развитии инфекционных и аллергических состояний, но и о наличии у пациента IgG4-сопряженной патологии. AbstractThe physiological role of IgG4 is poorly understood yet. It is known, that they, like other antibodies, are involved in the inactivation and removal of organism agent, which are identified as foreign antigens by immune system. IgG4 also release effector mechanisms: contact with the specialized immune cells, which perform phagocytosis foreign antigens or destruction of the infected cells by antibody-dependet cytotoxicity, after this interaction. Opinions about the ability to activate complement system are divided. The elevation concentration of that subclass immunoglobulins can be an indicator not only of development of infectious and allergic conditions, but also the presence of the IgG4-related disease in a patient´s organism.IgG4-rd is a recently selected group of pathological conditions and it is becoming relevant to study. It is because they include the conditions, which have been thought to be separate nosology previously. In recent years IgG4 -RD has been diagnosed more often, because it has been increasingly being recognized in the medical community. This review includes the latest information from the latest foreign publication. IgG4-СП -IgG4-сопряженная патология, Tregs -регуляторные Т-клетки, АИП -аутоиммунный панкреатит, ГН -гломерулонефрит, ИССХ -IgG4-сопряженный склерозирующий холангит, ПСХ -первичный склерозирующий холангит, ТИН -тубулоинтерстициаль-ный нефрит, ЭРХПГ -эндоскопическая ретроградная холангиопанкреатография Key words: ВведениеИммуноглобулины G составляют 75% от общего количества циркулирующих антител, а все осталь-ные классы иммуноглобулинов -суммарно около 25%. IgG продуцируются и накапливаются в орга-низме в больших количествах, чем IgM. Кроме того, они обладают более высоким специфическим срод-ством к соответствующим детерминантам антиге-нов и образуют с ними более прочные иммунные *Контакты/Contacts.

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“…to infection) and may also present as a mass lesion, is categorized as lymphocytic, granulomatous, xanthomatous and necrotizing based on histopathology 2 . Hypophysitis associated with IgG4-positive plasma cells has also been described 3,4 . In evaluating a pituitary mass lesion that reveals histologic evidence of a robust inflammatory component, LCH should enter into the differential diagnosis.…”

Section: Introductionmentioning

confidence: 96%

CD1a Reactivity in Non-neoplastic Adenohypophysis

Pisapia

Rosenblum²,

Lavi³

2016

American Journal of Surgical Pathology

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Within the differential diagnosis of patients presenting with sellar or suprasellar lesions is Langerhans cell histiocytosis (LCH). CD1a staining is frequently used to identify the presence of an abnormal proliferation of Langerhans cells on histological sections and contributes to the diagnosis of LCH. Here, we report that the MTB-1 monoclonal antibody against the CD1a antigen reacts to native adenohypophyseal epithelial cells. We show that immunohistochemistry for CD1a exhibits strong positivity in all autopsy and surgically resected non-neoplastic adenohypophysis tested. Thus, CD1a positivity by itself should be interpreted with caution, and we recommend the routine use of a panel of stains including CD1a, Langerin, and synaptophysin in conjunction with morphological analysis before a diagnosis of LCH is rendered. In addition, we find that pituitary adenomas fail to stain for CD1a prompting consideration of the utility of this stain as a marker for non-neoplastic gland.

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Cerebral involvement in IgG4-related disease

Cited by 35 publications

References 34 publications

Neurological Manifestations of IgG4-Related Disease

Neurological Manifestations of IgG4-Related Disease

Igg4-Related Disease: Condition of the Problem

CD1a Reactivity in Non-neoplastic Adenohypophysis

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