Involvement of two or more sets of lacrimal glands and/or major salivary glands is related to greater systemic disease activity due to multi-organ involvement in IgG4-related dacryoadenitis/sialadenitis

Mod Rheumatol. 2021 Nov;31(6):1164-1170. doi: 10.1080/14397595.2021.1878623. Epub 2021 Feb 11.

Abstract

Objectives: In IgG4-related dacryoadenitis and/or sialadenitis (IgG4-DS), involvement of two or more sets of lacrimal glands (LGs) and/or major salivary glands (MSGs) is regarded as a specific finding with diagnostic significance. This study aimed to clarify the influence of this factor on the overall clinical picture of IgG4-DS.

Methods: We retrospectively reviewed the medical records of 130 patients with IgG4-related disease, 97 of whom were diagnosed with IgG4-DS. We determined their clinical features according to the presence/absence of involvement of ≥2 sets of LGs and/or MSGs and compared the results with those obtained in 33 DS-limited patients.

Results: The IgG4-DS patients comprised 60 men and 37 women (median age 65 years). The median serum IgG4 level at diagnosis was 548 mg/dL. The patients with involvement of ≥2 sets (n = 44) had significantly more affected organs, lower serum C3 and C4 levels, and a tendency to have higher serum IgG levels and IgG4-RD responder index than did those without it (n = 53). In the 33 DS-limited patients, these two groups had no significant differences in clinical features.

Conclusions: Involvement of ≥2 sets of LGs and/or MSGs suggests greater systemic disease activity mainly reflected by involvement of more organs.

Keywords: IgG4-related dacryoadenitis and sialadenitis; IgG4-related disease; disease activity; two sets.

MeSH terms

  • Aged
  • Dacryocystitis* / diagnosis
  • Female
  • Humans
  • Immunoglobulin G
  • Lacrimal Apparatus*
  • Male
  • Retrospective Studies
  • Salivary Glands
  • Sialadenitis* / diagnosis

Substances

  • Immunoglobulin G