Prostate and pancreas involvement are linked in IgG4-related disease

Semin Arthritis Rheum. 2020 Dec;50(6):1245-1251. doi: 10.1016/j.semarthrit.2020.09.002. Epub 2020 Sep 15.

Abstract

Objective: Prostate involvement by IgG4-related disease (IgG4-RD) is a rarely described organ manifestation and knowledge regarding its frequency and clinical features is limited.

Methods: From a single-center cohort, 168 male patients were examined who satisfied the 2019 ACR/EULAR classification criteria or 2012 consensus histopathologic criteria for IgG4-RD.

Results: Prostate involvement were identified in 25 (15%) of these cases. The majority of patients with IgG4-RD involving the prostate gland (80%) were symptomatic at presentation with incomplete voiding (64%), urinary frequency (52%), and urinary hesitancy (48%) being the most common complaints. The radiologic presentation of prostate disease is most often a focal abnormality suggesting inflammation rather than a mass lesion. While most patients with IgG4-related prostate disease (89%) experienced recurrence after or during glucocorticoid tapering, patients treated with B cell targeted therapy in this series experienced clinical improvement and were tapered off of glucocorticoids. Additionally, patients with IgG4-RD involving the pancreas (p = < 0.001) were more likely to have prostate involvement than were those with other types of organ involvement.

Conclusion: This report provides the first comprehensive clinical description of IgG4-RD involving the prostate gland and links this manifestation with pancreatic involvement.

Keywords: Autoimmune pancreatitis; IgG4-related disease; Prostate; Prostatitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases*
  • Glucocorticoids
  • Humans
  • Immunoglobulin G
  • Immunoglobulin G4-Related Disease*
  • Male
  • Pancreas / diagnostic imaging
  • Prostate / diagnostic imaging

Substances

  • Glucocorticoids
  • Immunoglobulin G