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Published in: Clinical Rheumatology 9/2013

01-09-2013 | Review Article

The great mimicker: IgG4-related disease

Authors: Rodolfo Perez Alamino, Luis R. Espinoza, Arnold H. Zea

Published in: Clinical Rheumatology | Issue 9/2013

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Abstract

IgG4-related disease is defined as a multi-organ systemic disorder with pathological findings affecting a wide range of organ systems. The condition unifies a large number of clinical diagnoses previously considered as being confined to single organ systems. At present, several issues related to its pathophysiology remained controversial, including the natural history of the disease, the pathogenic role of IgG4, and its use as a biomarker. Glucocorticoids are considered the treatment of choice for remission induction of IgG4-related disease manifestations; however, concerns regarding duration of therapy and management of refractory disease remained to be elucidated.
Literature
1.
go back to reference Hamano H, Kawa S, Horiuchi A et al (2001) High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 344:732–738PubMedCrossRef Hamano H, Kawa S, Horiuchi A et al (2001) High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 344:732–738PubMedCrossRef
2.
go back to reference Umehara H, Okazaki K, Masaki Y, Research Program for Intractable Disease by Ministry of Health, Labor and Welfare (MHLW) Japan G4 Team et al (2012) A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details. Mod Rheumatol 22:1–14PubMedCrossRef Umehara H, Okazaki K, Masaki Y, Research Program for Intractable Disease by Ministry of Health, Labor and Welfare (MHLW) Japan G4 Team et al (2012) A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details. Mod Rheumatol 22:1–14PubMedCrossRef
3.
go back to reference Nirula A, Glaser SM, Kalled SL et al (2011) What is IgG4? A review of the biology of a unique immunoglobulin subtype. Curr Opin Rheumatol 23:119–124PubMedCrossRef Nirula A, Glaser SM, Kalled SL et al (2011) What is IgG4? A review of the biology of a unique immunoglobulin subtype. Curr Opin Rheumatol 23:119–124PubMedCrossRef
5.
go back to reference Rispens T, Ooijevaar-de Heer P, Bende O et al (2011) Mechanism of immunoglobulin G4 Fab-arm exchange. J Am Chem Soc 133:10302–10311PubMedCrossRef Rispens T, Ooijevaar-de Heer P, Bende O et al (2011) Mechanism of immunoglobulin G4 Fab-arm exchange. J Am Chem Soc 133:10302–10311PubMedCrossRef
6.
7.
go back to reference Kawa S, Ota M, Yoshizawa K et al (2002) HLA DRB1 0405-DQB1 0401 haplotype is associated with autoimmune pancreatitis in the Japanese population. Gastroenterology 122:1264–1269PubMedCrossRef Kawa S, Ota M, Yoshizawa K et al (2002) HLA DRB1 0405-DQB1 0401 haplotype is associated with autoimmune pancreatitis in the Japanese population. Gastroenterology 122:1264–1269PubMedCrossRef
8.
go back to reference Park DH, Kim M, Oh H et al (2008) Substitution of aspartic acid at position 57 of the DQ beta1 affects relapse of autoimmune pancreatitis. Gastroenterology 134:440–446CrossRef Park DH, Kim M, Oh H et al (2008) Substitution of aspartic acid at position 57 of the DQ beta1 affects relapse of autoimmune pancreatitis. Gastroenterology 134:440–446CrossRef
9.
go back to reference Chang MC, Chang YT, Tien YW et al (2007) T-cell regulatory gene CTLA-4 polymorphism/haplotype association with autoimmune pancreatitis. Clin Chem 53:1700–1705PubMedCrossRef Chang MC, Chang YT, Tien YW et al (2007) T-cell regulatory gene CTLA-4 polymorphism/haplotype association with autoimmune pancreatitis. Clin Chem 53:1700–1705PubMedCrossRef
10.
go back to reference Umemura T, Ota M, Hamano H et al (2008) Association of autoimmune pancreatitis with cytotoxic T-lymphocyte antigen 4 gene polymorphisms in Japanese patients. Am J Gastroenterol 103:588–594PubMedCrossRef Umemura T, Ota M, Hamano H et al (2008) Association of autoimmune pancreatitis with cytotoxic T-lymphocyte antigen 4 gene polymorphisms in Japanese patients. Am J Gastroenterol 103:588–594PubMedCrossRef
11.
go back to reference Umemura T, Ota M, Hamano H et al (2006) Genetic association of Fc receptor-like 3 polymorphisms with autoimmune pancreatitis in Japanese patients. Gut 55:1367–1368PubMedCrossRef Umemura T, Ota M, Hamano H et al (2006) Genetic association of Fc receptor-like 3 polymorphisms with autoimmune pancreatitis in Japanese patients. Gut 55:1367–1368PubMedCrossRef
12.
go back to reference Nishimori I, Miyaji E, Morimoto K et al (2005) Serum antibodies to carbonic anhydrase IV in patients with autoimmune pancreatitis. Gut 54:274–281PubMedCrossRef Nishimori I, Miyaji E, Morimoto K et al (2005) Serum antibodies to carbonic anhydrase IV in patients with autoimmune pancreatitis. Gut 54:274–281PubMedCrossRef
13.
go back to reference Löhr JM, Faissner R, Koczan D et al (2010) Autoantibodies against the exocrine pancreas in autoimmune pancreatitis: gene and protein expression profiling and immunoassays identify pancreatic enzymes as a major target of the inflammatory process. Am J Gastroenterol 105:2060–2071PubMedCrossRef Löhr JM, Faissner R, Koczan D et al (2010) Autoantibodies against the exocrine pancreas in autoimmune pancreatitis: gene and protein expression profiling and immunoassays identify pancreatic enzymes as a major target of the inflammatory process. Am J Gastroenterol 105:2060–2071PubMedCrossRef
14.
go back to reference Asada M, Nishio A, Uchida K et al (2006) Identification of a novel autoantibody against pancreatic secretory trypsin inhibitor in patients with autoimmune pancreatitis. Pancreas 33:20–26PubMedCrossRef Asada M, Nishio A, Uchida K et al (2006) Identification of a novel autoantibody against pancreatic secretory trypsin inhibitor in patients with autoimmune pancreatitis. Pancreas 33:20–26PubMedCrossRef
15.
go back to reference Yamamoto M, Naishiro Y, Suzuki C et al (2010) Proteomics analysis in 28 patients with systemic IgG4-related plasmacytic syndrome. Rheumatol Int 30:565–568PubMedCrossRef Yamamoto M, Naishiro Y, Suzuki C et al (2010) Proteomics analysis in 28 patients with systemic IgG4-related plasmacytic syndrome. Rheumatol Int 30:565–568PubMedCrossRef
16.
go back to reference Frulloni L, Lunardi C, Simone R et al (2009) Identification of a novel antibody associated with autoimmune pancreatitis. N Engl J Med 361:2135–2142PubMedCrossRef Frulloni L, Lunardi C, Simone R et al (2009) Identification of a novel antibody associated with autoimmune pancreatitis. N Engl J Med 361:2135–2142PubMedCrossRef
17.
go back to reference Guarneri F, Guarneri C, Benvenga S (2005) Helicobacter pylori and autoimmune pancreatitis: role of carbonic anhydrase via molecular mimicry? J Cell Mol Med 9:741–744PubMedCrossRef Guarneri F, Guarneri C, Benvenga S (2005) Helicobacter pylori and autoimmune pancreatitis: role of carbonic anhydrase via molecular mimicry? J Cell Mol Med 9:741–744PubMedCrossRef
18.
go back to reference Akitake R, Watanabe T, Zaima C et al (2010) Possible involvement of T-helper type 2 responses to Toll-like receptor ligands in IgG4-related sclerosing disease. Gut 59:542–545PubMedCrossRef Akitake R, Watanabe T, Zaima C et al (2010) Possible involvement of T-helper type 2 responses to Toll-like receptor ligands in IgG4-related sclerosing disease. Gut 59:542–545PubMedCrossRef
19.
go back to reference Kanari H, Kagami S, Kashiwakuma D et al (2010) Role of Th2 cells in IgG4-related lacrimal gland enlargement. Int Arch Allergy Immunol 152(Suppl 1):47–53PubMedCrossRef Kanari H, Kagami S, Kashiwakuma D et al (2010) Role of Th2 cells in IgG4-related lacrimal gland enlargement. Int Arch Allergy Immunol 152(Suppl 1):47–53PubMedCrossRef
20.
go back to reference Suzuki K, Tamaru J, Okuyama A et al (2010) IgG4-positive multi-organ lymphoproliferative syndrome manifesting as chronic symmetrical sclerosing dacryo-sialadenitis with subsequent secondary portal hypertension and remarkable IgG4-linked IL-4 elevation. Rheumatology (Oxford) 49:1789–1791CrossRef Suzuki K, Tamaru J, Okuyama A et al (2010) IgG4-positive multi-organ lymphoproliferative syndrome manifesting as chronic symmetrical sclerosing dacryo-sialadenitis with subsequent secondary portal hypertension and remarkable IgG4-linked IL-4 elevation. Rheumatology (Oxford) 49:1789–1791CrossRef
21.
go back to reference Kamisawa T, Anjiki H, Egawa N et al (2009) Allergic manifestations in autoimmune pancreatitis. Eur J Gastroenterol Hepatol 21:1136–1139PubMedCrossRef Kamisawa T, Anjiki H, Egawa N et al (2009) Allergic manifestations in autoimmune pancreatitis. Eur J Gastroenterol Hepatol 21:1136–1139PubMedCrossRef
22.
go back to reference Miyoshi H, Uchida K, Taniguchi T et al (2008) Circulating naive and CD4+CD25 high regulatory cells in patients with autoimmune pancreatitis. Pancreas 36:133–140PubMedCrossRef Miyoshi H, Uchida K, Taniguchi T et al (2008) Circulating naive and CD4+CD25 high regulatory cells in patients with autoimmune pancreatitis. Pancreas 36:133–140PubMedCrossRef
23.
go back to reference Detlefsen S, Sipos B, Zhao J et al (2008) Autoimmune pancreatitis: expression and cellular source of profibrotic cytokines and their receptors. Am J Surg Pathol 32:986–995PubMedCrossRef Detlefsen S, Sipos B, Zhao J et al (2008) Autoimmune pancreatitis: expression and cellular source of profibrotic cytokines and their receptors. Am J Surg Pathol 32:986–995PubMedCrossRef
24.
go back to reference Kamisawa T, Egawa N, Nakajima H (2003) Autoimmune pancreatitis is a systemic autoimmune disease. Am J Gastroenterol 98:2811–2812PubMedCrossRef Kamisawa T, Egawa N, Nakajima H (2003) Autoimmune pancreatitis is a systemic autoimmune disease. Am J Gastroenterol 98:2811–2812PubMedCrossRef
25.
go back to reference Stone J, Khosroshahi A, Deshpande V et al (2012) Recommendations for the nomenclature of IgG4-related disease and its individual organ system manifestations. Arthritis Rheum 64:3061–3067PubMedCrossRef Stone J, Khosroshahi A, Deshpande V et al (2012) Recommendations for the nomenclature of IgG4-related disease and its individual organ system manifestations. Arthritis Rheum 64:3061–3067PubMedCrossRef
26.
go back to reference Kamisawa T, Takuma K, Egawa N et al (2010) Autoimmune pancreatitis and IgG4-related sclerosing disease. Nat Rev Gastroenterol Hepatol 7:401–409PubMedCrossRef Kamisawa T, Takuma K, Egawa N et al (2010) Autoimmune pancreatitis and IgG4-related sclerosing disease. Nat Rev Gastroenterol Hepatol 7:401–409PubMedCrossRef
27.
go back to reference Stone J, Khosroshahi A, Hilgenberg A et al (2009) IgG4-related systemic disease and lymphoplasmacytic aortitis. Arthritis Rheum 60:3139–3145PubMedCrossRef Stone J, Khosroshahi A, Hilgenberg A et al (2009) IgG4-related systemic disease and lymphoplasmacytic aortitis. Arthritis Rheum 60:3139–3145PubMedCrossRef
28.
go back to reference Stone J, Caruso P, Deshpande V (2009) Case records of the Massachusetts General Hospital. Case 24–2009: a 26-year-old woman with painful swelling of the neck. N Engl J Med 361:511–518PubMedCrossRef Stone J, Caruso P, Deshpande V (2009) Case records of the Massachusetts General Hospital. Case 24–2009: a 26-year-old woman with painful swelling of the neck. N Engl J Med 361:511–518PubMedCrossRef
29.
go back to reference Stone J, Patel V, Oliveira G et al (2012) Case records of the Massachusetts General Hospital. Case 38–2012: a 60-year-old man with abdominal pain and aortic aneurysms. N Eng J Med 367:2335–2346CrossRef Stone J, Patel V, Oliveira G et al (2012) Case records of the Massachusetts General Hospital. Case 38–2012: a 60-year-old man with abdominal pain and aortic aneurysms. N Eng J Med 367:2335–2346CrossRef
30.
go back to reference Khosroshahi A, Stone J (2011) A clinical overview of IgG4-related systemic disease. Curr Opin Rheumatol 23:57–66PubMedCrossRef Khosroshahi A, Stone J (2011) A clinical overview of IgG4-related systemic disease. Curr Opin Rheumatol 23:57–66PubMedCrossRef
31.
go back to reference Zen Y, Nakanuma Y (2010) IgG4-related disease. A cross-sectional study of 114 patients. Am J Surg Pathol 34:1812–1819PubMedCrossRef Zen Y, Nakanuma Y (2010) IgG4-related disease. A cross-sectional study of 114 patients. Am J Surg Pathol 34:1812–1819PubMedCrossRef
33.
go back to reference Yoshida K, Toki F, Takeuchi T et al (1995) Chronic pancreatitis caused by an autoimmune abnormality: proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 40:1561–1568PubMedCrossRef Yoshida K, Toki F, Takeuchi T et al (1995) Chronic pancreatitis caused by an autoimmune abnormality: proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 40:1561–1568PubMedCrossRef
34.
go back to reference Sahani D, Kalva S, Farrell J et al (2004) Autoimmune pancreatitis: imaging features. Radiology 233:345–352PubMedCrossRef Sahani D, Kalva S, Farrell J et al (2004) Autoimmune pancreatitis: imaging features. Radiology 233:345–352PubMedCrossRef
35.
go back to reference Ghazale A, Chari S, Zhang L et al (2008) Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy. Gastroenterology 134:706–715PubMedCrossRef Ghazale A, Chari S, Zhang L et al (2008) Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy. Gastroenterology 134:706–715PubMedCrossRef
36.
go back to reference Umemura T, Zen Y, Hamano H et al (2007) IgG4 associated autoimmune hepatitis: a differential diagnosis for classical autoimmune hepatitis. Gut 56:1471–1472PubMedCrossRef Umemura T, Zen Y, Hamano H et al (2007) IgG4 associated autoimmune hepatitis: a differential diagnosis for classical autoimmune hepatitis. Gut 56:1471–1472PubMedCrossRef
37.
go back to reference Geyer J, Ferry J, Harris N et al (2010) Chronic sclerosing sialadenitis (Küttner tumor) is an IgG4-associated disease. Am J Surg Pathol 34:202–210PubMedCrossRef Geyer J, Ferry J, Harris N et al (2010) Chronic sclerosing sialadenitis (Küttner tumor) is an IgG4-associated disease. Am J Surg Pathol 34:202–210PubMedCrossRef
38.
go back to reference Sato Y, Ohshima K, Ichimura K et al (2008) Ocular adrenal IgG4-related disease has uniform clinicopathology. Pathol Int 58:465–470PubMedCrossRef Sato Y, Ohshima K, Ichimura K et al (2008) Ocular adrenal IgG4-related disease has uniform clinicopathology. Pathol Int 58:465–470PubMedCrossRef
39.
go back to reference Espinoza GM (2010) Orbital inflammatory pseudotumors: etiology, differential diagnosis and management. Curr Rheumatol Report 12:443–447CrossRef Espinoza GM (2010) Orbital inflammatory pseudotumors: etiology, differential diagnosis and management. Curr Rheumatol Report 12:443–447CrossRef
40.
go back to reference Dahlgren M, Khosroshahi A, Nielsen G et al (2010) Riedel's thyroiditis and multifocal fibrosclerosis are part of the IgG4-related systemic disease spectrum. Arthritis Care Res (Hoboken) 62:1312–1318CrossRef Dahlgren M, Khosroshahi A, Nielsen G et al (2010) Riedel's thyroiditis and multifocal fibrosclerosis are part of the IgG4-related systemic disease spectrum. Arthritis Care Res (Hoboken) 62:1312–1318CrossRef
41.
go back to reference Saeki T, Nishi S, Imai N et al (2010) Clinicopathological characteristics of patients with IgG4-related tubulointerstitial nephritis. Kidney Int 10:1016–1023CrossRef Saeki T, Nishi S, Imai N et al (2010) Clinicopathological characteristics of patients with IgG4-related tubulointerstitial nephritis. Kidney Int 10:1016–1023CrossRef
42.
go back to reference Cornell L, Chicano S, Deshpande V et al (2007) Pseudotumors due to IgG4 immune-complex tubulointerstitial nephritis associated with autoimmune pancreatocentric disease. Am J Surg Pathol 31:1586–1597PubMedCrossRef Cornell L, Chicano S, Deshpande V et al (2007) Pseudotumors due to IgG4 immune-complex tubulointerstitial nephritis associated with autoimmune pancreatocentric disease. Am J Surg Pathol 31:1586–1597PubMedCrossRef
43.
go back to reference Stone J (2011) Aortitis, periaortitis and retroperitoneal fibrosis, as manifestations of IgG4-related systemic disease. Curr Opin Rheumatol 23:88–94PubMedCrossRef Stone J (2011) Aortitis, periaortitis and retroperitoneal fibrosis, as manifestations of IgG4-related systemic disease. Curr Opin Rheumatol 23:88–94PubMedCrossRef
44.
go back to reference Stone J, Khosroshahi A, Deshpande V et al (2010) IgG4-related systemic disease accounts for a significant proportion of thoracic lymphoplasmacytic aortitis cases. Arthrit Care Res 62:316–322 Stone J, Khosroshahi A, Deshpande V et al (2010) IgG4-related systemic disease accounts for a significant proportion of thoracic lymphoplasmacytic aortitis cases. Arthrit Care Res 62:316–322
45.
go back to reference Zen Y, Onodera M, Inoue D et al (2009) Retroperitoneal fibrosis: a clinicopathologic study with respect to immunoglobulin G4. Am J Surg Pathol 33:1833–1839PubMedCrossRef Zen Y, Onodera M, Inoue D et al (2009) Retroperitoneal fibrosis: a clinicopathologic study with respect to immunoglobulin G4. Am J Surg Pathol 33:1833–1839PubMedCrossRef
46.
go back to reference Yamashita K, Haga H, Kobashi Y et al (2008) Lung involvement in IgG4-related lymphoplasmacytic vasculitis and interstitial fibrosis: report of 3 cases and review of the literature. Am J Surg Pathol 32:1620–1626PubMedCrossRef Yamashita K, Haga H, Kobashi Y et al (2008) Lung involvement in IgG4-related lymphoplasmacytic vasculitis and interstitial fibrosis: report of 3 cases and review of the literature. Am J Surg Pathol 32:1620–1626PubMedCrossRef
47.
go back to reference Zen Y, Inoue D, Kitao A et al (2009) IgG4-related lung and pleural disease: a clinicopathologic study of 21 cases. Am J Surg Pathol 33:1886–1893PubMedCrossRef Zen Y, Inoue D, Kitao A et al (2009) IgG4-related lung and pleural disease: a clinicopathologic study of 21 cases. Am J Surg Pathol 33:1886–1893PubMedCrossRef
48.
go back to reference Sato Y, Kojima M, Takata K et al (2009) Systemic IgG4-related lymphadenopathy: a clinic and pathologic comparison to multicentric Castleman's disease. Mod Pathol 22:589–599PubMedCrossRef Sato Y, Kojima M, Takata K et al (2009) Systemic IgG4-related lymphadenopathy: a clinic and pathologic comparison to multicentric Castleman's disease. Mod Pathol 22:589–599PubMedCrossRef
49.
go back to reference Chan S, Cheuk W, Chan K et al (2009) IgG4-related sclerosing pachymeningitis: a previously unrecognized form of central nervous system involvement in IgG4-related sclerosing disease. Am J Surg Pathol 33:1249–1252PubMedCrossRef Chan S, Cheuk W, Chan K et al (2009) IgG4-related sclerosing pachymeningitis: a previously unrecognized form of central nervous system involvement in IgG4-related sclerosing disease. Am J Surg Pathol 33:1249–1252PubMedCrossRef
50.
go back to reference Cheuk W, Chan A, Lam W et al (2009) IgG4-related sclerosing mastitis: description of a new member of the IgG4-releted sclerosing diseases. Am J Surg Pathol 33:1058–1064PubMedCrossRef Cheuk W, Chan A, Lam W et al (2009) IgG4-related sclerosing mastitis: description of a new member of the IgG4-releted sclerosing diseases. Am J Surg Pathol 33:1058–1064PubMedCrossRef
51.
go back to reference Haraguchi A, Era A, Yasui J et al (2010) Putative IgG4-related pituitary disease with hypopituitarism and/or diabetes insipidus accompanied with elevated serum levels of IgG4. Endocr J 57:719–725PubMedCrossRef Haraguchi A, Era A, Yasui J et al (2010) Putative IgG4-related pituitary disease with hypopituitarism and/or diabetes insipidus accompanied with elevated serum levels of IgG4. Endocr J 57:719–725PubMedCrossRef
52.
go back to reference Yoshimura Y, Takeda S, Ieki Y et al (2006) IgG4-associated prostatitis complicating autoimmune pancreatitis. Intern Med 45:897–901PubMedCrossRef Yoshimura Y, Takeda S, Ieki Y et al (2006) IgG4-associated prostatitis complicating autoimmune pancreatitis. Intern Med 45:897–901PubMedCrossRef
53.
go back to reference Takikita-Suzuki M, Ishida M, Okabe H (2010) Re-evaluation of IgG4 in systemic fibroinflammatory disease with intracardiac involvement. Hum Pathol 41:458–459PubMedCrossRef Takikita-Suzuki M, Ishida M, Okabe H (2010) Re-evaluation of IgG4 in systemic fibroinflammatory disease with intracardiac involvement. Hum Pathol 41:458–459PubMedCrossRef
54.
go back to reference Cheuk W, Lee K, Chong L et al (2009) IgG4-related sclerosing disease. A potential new etiology of cutaneous pseudolymphoma. Am J Surg Pathol 33:1713–1719PubMedCrossRef Cheuk W, Lee K, Chong L et al (2009) IgG4-related sclerosing disease. A potential new etiology of cutaneous pseudolymphoma. Am J Surg Pathol 33:1713–1719PubMedCrossRef
55.
go back to reference Deshpande V, Zen Y, Chan J et al (2012) Consensus statement on the pathology of IgG4-related disease. Mod Pathol 25:1181–1192PubMedCrossRef Deshpande V, Zen Y, Chan J et al (2012) Consensus statement on the pathology of IgG4-related disease. Mod Pathol 25:1181–1192PubMedCrossRef
56.
go back to reference Khosroshahi A, Cheryk L, Carruthers M et al (2012) Prozone phenomenom leads to low IgG4 concentrations in IgG4-related disease (Abstract 2527). Arthritis Rheum 64(10 Suppl):S1067 Khosroshahi A, Cheryk L, Carruthers M et al (2012) Prozone phenomenom leads to low IgG4 concentrations in IgG4-related disease (Abstract 2527). Arthritis Rheum 64(10 Suppl):S1067
57.
go back to reference Khosroshahi A, Stone J (2011) Treatment approaches to IgG4-related systemic disease. Curr Opin Rheumatol 23:67–71PubMedCrossRef Khosroshahi A, Stone J (2011) Treatment approaches to IgG4-related systemic disease. Curr Opin Rheumatol 23:67–71PubMedCrossRef
58.
go back to reference Kamisawa T, Okazaki K, Kawa S et al (2010) Japanese consensus guidelines for management of autoimmune pancreatitis: III. Treatment and prognosis of AIP. J Gastroenterol 45:471–477PubMedCrossRef Kamisawa T, Okazaki K, Kawa S et al (2010) Japanese consensus guidelines for management of autoimmune pancreatitis: III. Treatment and prognosis of AIP. J Gastroenterol 45:471–477PubMedCrossRef
59.
60.
go back to reference Khosroshahi A, Bloch D, Deshpande V et al (2010) Rituximab therapy leads to rapid decline of serum IgG4 levels and prompt clinical improvement in IgG4-related systemic disease. Arthritis Rheum 62:1755–1762PubMedCrossRef Khosroshahi A, Bloch D, Deshpande V et al (2010) Rituximab therapy leads to rapid decline of serum IgG4 levels and prompt clinical improvement in IgG4-related systemic disease. Arthritis Rheum 62:1755–1762PubMedCrossRef
61.
go back to reference Khosroshahi A, Carruthers M, Deshpande V et al (2012) Rituximab for the treatment of IgG4-related disease: lessons from 10 consecutive patients. Medicine (Baltimore) 91:57–66CrossRef Khosroshahi A, Carruthers M, Deshpande V et al (2012) Rituximab for the treatment of IgG4-related disease: lessons from 10 consecutive patients. Medicine (Baltimore) 91:57–66CrossRef
Metadata
Title
The great mimicker: IgG4-related disease
Authors
Rodolfo Perez Alamino
Luis R. Espinoza
Arnold H. Zea
Publication date
01-09-2013
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 9/2013
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-013-2326-z

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