The Case Report And Clinical Analysis Of IgG4-related Disease In The Head And Neck

Objective :Through summarizing and analyzing the 6 cases of this study in head and neck of IgG4-related disease with the pathologic diagnosis,further to explore the characteristics,diagnosis and treatment,to improve the otolaryngologists’ the understanding of the disease.Methods:All clinical datas confirmed by pathology in Department of Otolaryngology-Head and Neck from 6 cases of IgG4-related disease undergoing surgical treatment and surgery in The Second Hospital of Jilin University were retrospectively analyzed.Analyses include the age of onset,the clinical symptoms,signs,pathological features,serological changes,imaging characteristics.In combination with the related literatures,summarizing the features of 6 cases IgG4-related disease of head and neck in otolaryngology.Briefly describes the treatment methods.Results:The average age of the 6 patients with IgG4-related disease included in the study.Respectively occurred in the submandibular gland(4 cases),lacrimal gland(1 case),facial ministry(1 case).Clinical manifestations have no significant specificity.None patients had other basic diseases,and no postoperative complications.The signs of the 6 patients were in the painless progressive swelling.The preoperatively serological results of case 1,case 2 were elevated IgG4 serum levels(normal range: 0.030 to 2.010 g/l).The imaging appearances are inflammatory changes of the lesions.CT showed lesions were soft tissue density shadow,MRI showed lesions were long T1 long T2 signal.The patients were performed to surgical resection,the first case was combined with glucocorticoid and immunosuppressive therapy after local anesthesia or general anesthesia surgical resection.All patients were followed up postoperative and no one showed recurrence or died.Conclusion:IgG4-related disease is a rarely clinical disease in the Head and Neck.In need of improving the otolaryngology doctors on the cognition of the disease,so that the patients get the accurate and timely treatment.In the diagnosis,by increasing serum IgG4 levels defined diagnostic value,which can be increased to varying degrees of IgG4-related disease diagnostic specificity.Glucocorticoid hormone is still a first-line treatment of drugs,for head and neck IgG4-related disease for surgery,in conjunction with the disease of the imaging assistance test results show that the surrounding gland without tumor invasion of the case,to reduce the scope of surgical loss,Retaining the organ function,feasible to retain the gland of the tumor nucleus surgery,postoperative and then with glucocorticoid hormones or immunosuppressive agents or biological agents(Anti-CD20 antibody),may reduce the possibility of recurrence.