Gallium SPECT/CT in evaluation of IgG4-related disease

Chuang, Tzyy‐Ling; Hsu, Bao-Bao; Chi, Chen-Lin; Wang, Yuh-Feng

doi:10.1097/md.0000000000004865

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…It is also worth noting that gallium SPECT/CT may also have potential clinical utility in the diagnosis and monitoring of IgG4-RD, particularly given its lower cost and more widespread availability [130]. …”

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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“…Surgical pericardiotomy to identify IgG4-positive cells in the pericardial specimen might have been useful; however, we did not perform pericardiotomy because the procedure requires general anesthesia, and there was a sufficient amount of pericardial fluid for a safe puncture in the present case (16). Although the usefulness of 18 F-fluorodeoxyglucose positron emission tomography/CT and 67 gallium single-photon emission CT have been indicated in terms of the sites and activities of inflammation and evaluating responses to steroid therapy, the findings of neither of these procedures are included in the current diagnostic criteria (13, 19, 20). The levels of IgG and IgG4 in pericardial fluid have not been described in the limited number of available reports; we therefore believe that the significance of this measurement remains unclear.…”

Section: Discussionmentioning

confidence: 99%

IgG4-related Pericarditis in which Oral Corticosteroid Therapy Was Effective

Arao¹,

Mase²,

Iwanami³

et al. 2019

Intern. Med.

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IgG4-related diseases (IgG4-RDs) have recently been reported in many organs other than the salivary, pancreatic and hepatobiliary systems. A 64-year-old woman was referred to our department for her abdominal fullness and cardiomegaly on chest X-ray. After draining the pericardial fluid, her symptom promptly diminished, and pericardial friction rubbing became clearly audible. Elevated serum levels of IgG and IgG4 and ureteral wall thickening on computed tomography suggested IgG4-RD. After the initiation of oral corticosteroid therapy, the pericardial effusion was resolved, and she has been in a steady-state condition for the past two years.

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“…Additionally, there have been suggestions for a role for gallium SPECT/CT in the diagnosis of IgG4-RD and its treatment response (43). As this test is cheaper and more readily available than FDG PET CT scan, if studies confirm that it offers similar diagnostic efficacy, it would be a better option (44).…”

Section: - Diagnosismentioning

confidence: 99%

Diagnostic and treatment workup for IgG4-related disease

Abraham

Khosroshahi

2017

Expert Review of Clinical Immunology

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Introduction IgG4-Related Disease is a newly recognized condition which is increasingly diagnosed by practitioners due to improvement in clinical awareness. Men and women have been found to be affected by this disease in various organs, more commonly with involvement of the salivary and lacrimal glands as well as pancreas and liver. Areas Covered The diagnosis and management of this condition remain challenging as biomarkers and therapies are being investigated. Hallmark features on histology are still the gold standard for confirmation of diagnosis, whereas serum IgG4 level has been shown to be neither necessary nor sufficient for the diagnosis. Glucocorticoids remain the most effective initial management for this condition while there are limited clinical trials on the effectiveness of maintenance therapy. Expert Commentary This review serves as an update on approaches for diagnosis and management of IgG4-RD. Most of the known data in this field comes from retrospective cohort studies and expert consensus guidelines but new ongoing prospective studies, clinical trials and better understanding of the pathogenesis of this condition are promising.

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Gallium SPECT/CT in evaluation of IgG4-related disease

Cited by 7 publications

References 23 publications

Neurological Manifestations of IgG4-Related Disease

Neurological Manifestations of IgG4-Related Disease

IgG4-related Pericarditis in which Oral Corticosteroid Therapy Was Effective

Diagnostic and treatment workup for IgG4-related disease

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