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Article: Immunoglobulin G4–related disease in Hong Kong: clinical features, treatment practices, and its association with multisystem disease

TitleImmunoglobulin G4–related disease in Hong Kong: clinical features, treatment practices, and its association with multisystem disease
Authors
Issue Date2017
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
Hong Kong Medical Journal, 2017, v. 23 n. 5, p. 446-453 How to Cite?
AbstractIntroduction: Immunoglobulin G4–related disease remains an under-recognised and evolving disease. Local data are sparse and previous publications have been limited to individual case reports or case series only. We conducted this study to review the clinical features, treatment practices, and factors associated with multisystem involvement in Hong Kong. We described the clinical features and treatment modalities of the largest cohort of immunoglobulin G4–related disease in our locality thus far. Methods: We retrospectively evaluated all patients with immunoglobulin G4–related disease between January 2003 and December 2015 in Queen Mary Hospital and combined this with patient data extracted from previous local publications. We analysed the clinical features, treatment practices, and factors associated with the number of organ systems involved. Results: A total of 104 patients (55 from Queen Mary Hospital and 49 from literature review) were identified. Patients were predominantly older men (mean [standard deviation] age, 61.9 [12.7] years; male-to-female ratio=3:1) and 94.4% had elevated pre-treatment serum immunoglobulin G4 levels. Hepatobiliary and pancreatic system (40.4%), salivary gland (33.7%), lymph node (29.8%), and eye (19.2%) were the most common organ systems involved. Lymphadenopathy was associated with glucocorticoid use (odds ratio=2.65; 95% confidence interval, 1.08-6.54; P=0.034). Pre-treatment serum immunoglobulin G4 levels correlated with the number of organ systems involved (β=0.347; P=0.004) and, specifically, more associated with patients having salivary gland involvement than those without (mean, 1109 mg/dL vs 599 mg/dL; P=0.012). Conclusion: We identified pre-treatment serum immunoglobulin G4 to be associated with multisystem disease, especially with salivary gland involvement, highlighting its potential for disease prognostication and monitoring. Increased physician awareness and multidisciplinary efforts are required for early diagnosis and optimal management of this masquerading disease.
Persistent Identifierhttp://hdl.handle.net/10722/247528
ISSN
2019 Impact Factor: 1.679
2015 SCImago Journal Rankings: 0.279
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, PH-
dc.contributor.authorKo, KL-
dc.contributor.authorHo, CTK-
dc.contributor.authorLau, LL-
dc.contributor.authorTsang, RKY-
dc.contributor.authorCheung, TT-
dc.contributor.authorLeung, WK-
dc.contributor.authorLau, WCS-
dc.date.accessioned2017-10-18T08:28:42Z-
dc.date.available2017-10-18T08:28:42Z-
dc.date.issued2017-
dc.identifier.citationHong Kong Medical Journal, 2017, v. 23 n. 5, p. 446-453-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/247528-
dc.description.abstractIntroduction: Immunoglobulin G4–related disease remains an under-recognised and evolving disease. Local data are sparse and previous publications have been limited to individual case reports or case series only. We conducted this study to review the clinical features, treatment practices, and factors associated with multisystem involvement in Hong Kong. We described the clinical features and treatment modalities of the largest cohort of immunoglobulin G4–related disease in our locality thus far. Methods: We retrospectively evaluated all patients with immunoglobulin G4–related disease between January 2003 and December 2015 in Queen Mary Hospital and combined this with patient data extracted from previous local publications. We analysed the clinical features, treatment practices, and factors associated with the number of organ systems involved. Results: A total of 104 patients (55 from Queen Mary Hospital and 49 from literature review) were identified. Patients were predominantly older men (mean [standard deviation] age, 61.9 [12.7] years; male-to-female ratio=3:1) and 94.4% had elevated pre-treatment serum immunoglobulin G4 levels. Hepatobiliary and pancreatic system (40.4%), salivary gland (33.7%), lymph node (29.8%), and eye (19.2%) were the most common organ systems involved. Lymphadenopathy was associated with glucocorticoid use (odds ratio=2.65; 95% confidence interval, 1.08-6.54; P=0.034). Pre-treatment serum immunoglobulin G4 levels correlated with the number of organ systems involved (β=0.347; P=0.004) and, specifically, more associated with patients having salivary gland involvement than those without (mean, 1109 mg/dL vs 599 mg/dL; P=0.012). Conclusion: We identified pre-treatment serum immunoglobulin G4 to be associated with multisystem disease, especially with salivary gland involvement, highlighting its potential for disease prognostication and monitoring. Increased physician awareness and multidisciplinary efforts are required for early diagnosis and optimal management of this masquerading disease.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleImmunoglobulin G4–related disease in Hong Kong: clinical features, treatment practices, and its association with multisystem disease-
dc.typeArticle-
dc.identifier.emailHo, CTK: ctkho@hkucc.hku.hk-
dc.identifier.emailTsang, RKY: rkytsang@hku.hk-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.emailLau, WCS: cslau@hku.hk-
dc.identifier.authorityTsang, RKY=rp01386-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityLeung, WK=rp01479-
dc.identifier.authorityLau, WCS=rp01348-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.12809/hkmj176229-
dc.identifier.pmid28862143-
dc.identifier.scopuseid_2-s2.0-85030999974-
dc.identifier.hkuros281839-
dc.identifier.volume23-
dc.identifier.issue5-
dc.identifier.spage446-
dc.identifier.epage453-
dc.identifier.isiWOS:000413741400005-
dc.publisher.placeHong Kong-
dc.identifier.issnl1024-2708-

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