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IgG4 guidelines

Yvonne L Lont, Luc E Coffeng, Sake J de Vlas, Allison Golden, Tala de Los Santos, Gonzalo J Domingo, Wilma A Stolk
BACKGROUND: Onchocerciasis is targeted for elimination in Africa through annual or biannual ivermectin mass drug administration (MDA). An immunodiagnostic test, based on the detection of human IgG4 antibodies in the blood to the Onchocerca volvulus-specific antigen Ov16, is one of the recommended tools for determining whether transmission is interrupted and mass treatment can stop. For different transmission settings, the relationship between post-MDA Ov16 antibody prevalence in children (measured 1 year after the last round of MDA) and the duration and coverage of MDA, the mf prevalence in the population, and the probability that onchocerciasis is eventually eliminated is explored through mathematical modelling...
January 2017: PLoS Neglected Tropical Diseases
Beatrice Ludwig-Kraus, Frank Bernhard Kraus
BACKGROUND: Laboratory quantification of IgG subclasses (IgGSc) is a well-established second-line tool for differential diagnosis of immune deficiencies. However, so far there is still no internationally approved standard available for IgGSc, and different assays are prone to produce divergent results. In this study, we evaluated the comparability and equivalence of two commercially available IgGSc assays, one being the Siemens IgGSc assay on a BN ProSpec analyzer and the other being The Binding Site (TBS) IgGSc assay on a Roche cobas c502 analyzer...
January 16, 2017: Journal of Clinical Laboratory Analysis
T Lakwo, R Garms, J Wamani, E M Tukahebwa, E Byamukama, A W Onapa, E Tukesiga, J Katamanywa, S Begumisa, P Habomugisha, D Oguttu, E Byamukama, F Richards, T R Unnasch, M Katabarwa
Uganda is the only country in sub-Saharan Africa whose onchocerciasis elimination programme extensively uses vector control and biannual treatment with ivermectin. The purpose of this study was to assess the impact of combined strategies on interrupting onchocerciasis transmission in the Kashoya-Kitomi focus. Mass Drug Administration annually (13 years) followed by biannual treatments (6 years) and ground larviciding (36 cycles in 3 years) with temephos (Abate(®), EC500) against Simulium neavei were conducted...
March 2017: Acta Tropica
Masayuki Akashi, Hiroki Yasudo, Masami Narita, Ichiro Nomura, Akira Akasawa, Motohiro Ebisawa, Takao Takahashi, Yukihiro Ohya
BACKGROUND: Egg allergy is one of the most common food allergies in young child. While oral immunotherapy (OIT) is not routinely recommended in current guidelines, it has been considered as a potential alternative treatment strategy. Studies on OIT for food allergies have been explored; however, no studies with control group have been reported in Japan. METHODS: The first oral food challenge test (OFC) was performed on participants before treatment to ensure the diagnosis and evaluate the threshold dose for egg by the way of double-blind, placebo-controlled food challenge (DBPCFC)...
December 3, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
A Kleger, T Seufferlein
CLINICAL ISSUE: IgG4-related diseases are rare but the incidence is continuously increasing. The pathophysiology is only incompletely understood. Multiorgan involvement correlates with high relapse rates, high serum IgG4 levels and an aggressive disease course, which is why diagnostics and therapy must be carried out rapidly and efficiently according to international guidelines despite all the difficulties. STANDARD TREATMENT: Currently the therapeutic standard is initial therapy (induction therapy) with glucocorticosteroids over a longer period of time and if necessary followed by low-dose maintenance therapy...
December 2016: Der Radiologe
Michelle M Williams, Hazem Mashaly, Vinay K Puduvalli, Ming Jin, Ehud Mendel
The authors report a case of immunoglobulin G4-related disease (IgG4-RD) presenting as a paraspinal, epidural mass. This disease encompasses a host of autoimmune conditions that were previously thought to be separate entities. It is characterized by fibrosis, mediated by the aberrant proliferation and tissue invasion of IgG4-positive plasma cells, which can occur in any organ. As with other autoimmune conditions, it tends to be responsive to steroids and other immunosuppressants. It can rarely present as a tumefactive lesion of the central nervous system, creating the potential for misdiagnosis (given its similar radiological appearance to malignancy) and mistreatment...
January 2017: Journal of Neurosurgery. Spine
Archana Shubhakar, Radoslaw P Kozak, Karli R Reiding, Louise Royle, Daniel I R Spencer, Daryl L Fernandes, Manfred Wuhrer
Monitoring glycoprotein therapeutics for changes in glycosylation throughout the drug's life cycle is vital, as glycans significantly modulate the stability, biological activity, serum half-life, safety, and immunogenicity. Biopharma companies are increasingly adopting Quality by Design (QbD) frameworks for measuring, optimizing, and controlling drug glycosylation. Permethylation of glycans prior to analysis by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) is a valuable tool for glycan characterization and for screening of large numbers of samples in QbD drug realization...
September 6, 2016: Analytical Chemistry
Bishan D Radotra, Ashish Aggarwal, Ankur Kapoor, Navneet Singla, Debajyoti Chatterjee
IgG4-related disease is relatively new disease entity and a rare one, and our knowledge of this entity continues to evolve. It was first described in the pancreas and since then has been described in virtually every organ. Spinal involvement resulting in pachymeningitis is rare, and there are only 8 reported cases of the same to date, with the cervicothoracic spine being the most commonly affected region. The authors describe 2 cases in which the patients presented with spinal compression resulting in myeloradiculopathy (Case 1) and radiculopathy (Case 2)...
December 2016: Journal of Neurosurgery. Spine
Guangqiao Zeng, Peiyan Zheng, Wenting Luo, Huimin Huang, Nili Wei, Baoqing Sun
Longitudinal data on serum specific sIgE and sIgG4 to allergen component of Dermatophagoides pteronyssinus (Der p) during allergen immunotherapy (AIT) are limited in Chinese populations. We serially followed up serum sIgE and sIgG4 to Der p and its components (Der p 1 and 2) in 51 Der p-sensitized children receiving guideline-based medications alone and additional 36-month AIT. The the Der p 1 and Der p 2 sIgE levels were elevated at 6 months and progressively declined from 12 months; the sIgG4 levels for Der p, Der p 1 and Der p 2 were increasing during the first year and reached a plateau thereafter; the sIgE/sIgG4 ratios for Der p 1 and Der p 2 decreased continuously from 6 through 24 months of AIT...
June 2016: Molecular Immunology
Haitham Odat, Mohannad Alqudah
The purpose of this study is to readdress the issue of primary humoral immunodeficiency frequency and pattern in medically resistant chronic rhinosinusitis (CRS) based on the new guidelines for CRS diagnosis and management. Two hundred and fifty-seven consecutive patients with refractory CRS were included in this study. The results of their IgA, IgM, IgG, and IgG subclasses were analyzed and compared with 75 age- and gender-matched control groups. The average age of CRS patients was 34 years (SD ± 13). In the refractory CRS group, there was no significant difference between patients with or without humoral immunodeficiency based on age, gender and status of allergy, polyps and revision...
October 2016: European Archives of Oto-rhino-laryngology
Nico Melzer, Tobias Ruck, Peter Fuhr, Ralf Gold, Reinhard Hohlfeld, Alexander Marx, Arthur Melms, Björn Tackenberg, Berthold Schalke, Christiane Schneider-Gold, Fritz Zimprich, Sven G Meuth, Heinz Wiendl
Myasthenia gravis (MG) is an autoimmune antibody-mediated disorder of neuromuscular synaptic transmission. The clinical hallmark of MG consists of fluctuating fatigability and weakness affecting ocular, bulbar and (proximal) limb skeletal muscle groups. MG may either occur as an autoimmune disease with distinct immunogenetic characteristics or as a paraneoplastic syndrome associated with tumors of the thymus. Impairment of central thymic and peripheral self-tolerance mechanisms in both cases is thought to favor an autoimmune CD4(+) T cell-mediated B cell activation and synthesis of pathogenic high-affinity autoantibodies of either the IgG1 and 3 or IgG4 subclass...
August 2016: Journal of Neurology
Cyriel Y Ponsioen
According to recent guidelines, primary sclerosing cholangitis (PSC) is diagnosed when a patient has a cholestatic liver enzyme profile, characteristic bile duct changes on imaging, and when secondary causes of sclerosing cholangitis are excluded. In patients with a clinical suspicion but normal cholangiography, a liver biopsy is indicated to establish a diagnosis of small duct PSC. Several other disease entities such as IgG4-associated cholangitis (IAC), cholangiocarcinoma (CCA), and secondary causes of sclerosing cholangitis such as choledocholithiasis, AIDS-cholangiopathy, ischemia, surgical bile duct trauma, or mast cell cholangiopathy can mimic PSC...
2015: Digestive Diseases
Frank Richards, Nidia Rizzo, Carlos Enrique Diaz Espinoza, Zoraida Morales Monroy, Carol Guillermina Crovella Valdez, Renata Mendizabal de Cabrera, Oscar de Leon, Guillermo Zea-Flores, Mauricio Sauerbrey, Alba Lucia Morales, Dalila Rios, Thomas R Unnasch, Hassan K Hassan, Robert Klein, Mark Eberhard, Ed Cupp, Alfredo Domínguez
We report the elimination of Onchocerca volvulus transmission from the Central Endemic Zone (CEZ) of onchocerciasis in Guatemala, the largest focus of this disease in the Americas and the first to be discovered in this hemisphere by Rodolfo Robles Valverde in 1915. Mass drug administration (MDA) with ivermectin was launched in 1988, with semiannual MDA coverage reaching at least 85% of the eligible population in > 95% of treatment rounds during the 12-year period, 2000-2011. Serial parasitological testing to monitor MDA impact in sentinel villages showed a decrease in microfilaria skin prevalence from 70% to 0%, and polymerase chain reaction (PCR)-based entomological assessments of the principal vector Simulium ochraceum s...
December 2015: American Journal of Tropical Medicine and Hygiene
S Vaidyanathan, C N Patel, A F Scarsbrook, F U Chowdhury
Integrated positron emission tomography/computed tomography (PET/CT) with the glucose analogue, 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG), is an evolving hybrid imaging technique in the evaluation of an important and diverse group of pathological conditions, which are characterised by infection and aseptic inflammation. With a rapidly expanding body of evidence, it is being increasingly recognised that, in addition to its established role in oncological imaging, FDG PET/CT also has clinical utility in suspected infection and inflammation...
July 2015: Clinical Radiology
Jun Tanaka, Atsushi Arai, Shigeto Hayashi, Yoshio Sakagami, Kota Araki, Seiji Kakiuchi, Tetsuhiko Nomura, Keiichi Kuwamura, Eiji Kohmura
We report a case of possible immunoglobulin G4-related disease(IgG4-RD)that resulted in complications such as retroperitoneal fibrosis and infundibulohypophysitis. The patient was a 72-year-old male who presented with polyuria and polydipsia. Magnetic resonance imaging(MRI)revealed a thickened pituitary stalk and contrast enhancement with gadolinium. T1-weighted imaging revealed that the posterior pituitary high-signal zone had disappeared. Central diabetes insipidus was diagnosed on the basis of results of the hypertonic saline test...
June 2014: No Shinkei Geka. Neurological Surgery
Terumi Kamisawa, Kazuichi Okazaki, Shigeyuki Kawa, Tetsuhide Ito, Kazuo Inui, Hiroyuki Irie, Takayoshi Nishino, Kenji Notohara, Isao Nishimori, Shigeki Tanaka, Toshimasa Nishiyama, Koichi Suda, Keiko Shiratori, Masao Tanaka, Tooru Shimosegawa
The standard treatment for autoimmune pancreatitis (AIP) is steroid therapy, although some patients improve spontaneously. Indications for steroid therapy in AIP patients are symptoms such as obstructive jaundice, abdominal pain, back pain, and the presence of symptomatic extrapancreatic lesions. Prior to steroid therapy, obstructive jaundice should be managed by biliary drainage, and blood glucose levels should be controlled in patients with diabetes mellitus. The recommended initial oral prednisolone dose for induction of remission is 0...
June 2014: Journal of Gastroenterology
Kazuichi Okazaki, Takashi Tomiyama, Toshiyuki Mitsuyama, Kimi Sumimoto, Kazushige Uchida
Recent studies suggested the existence of two subtypes of autoimmune pancreatitis (AIP): type 1 related with IgG4 as the pancreatic manifestation of IgG4-related disease (IgG4-RD), and type 2 related with a granulocytic epithelial lesion. Apart from type 2 AIP, the characteristic features of type 1 AIP are increased serum IgG4 levels, lymphoplasmacytic sclerosing pancreatitis (abundant infiltration of IgG4+ plasmacytes and lymphocytes, storiform fibrosis, and obliterative phlebitis), extra-pancreatic manifestations of IgG4-RD (e...
April 2014: Autoimmunity Reviews
Kirsten Boonstra, Emma L Culver, Lucas Maillette de Buy Wenniger, Marianne J van Heerde, Karel J van Erpecum, Alexander C Poen, Karin M J van Nieuwkerk, B W Marcel Spanier, Ben J M Witteman, Hans A R E Tuynman, Nan van Geloven, Henk van Buuren, Roger W Chapman, Eleanor Barnes, Ulrich Beuers, Cyriel Y Ponsioen
UNLABELLED: The recent addition of immunoglobulin (Ig)G4-associated cholangitis (IAC), also called IgG4-related sclerosing cholangitis (IRSC), to the spectrum of chronic cholangiopathies has created the clinical need for reliable methods to discriminate between IAC and the more common cholestatic entities, primary (PSC) and secondary sclerosing cholangitis. The current American Association for the Study of Liver Diseases practice guidelines for PSC advise on the measurement of specific Ig (sIg)G4 in PSC patients, but interpretation of elevated sIgG4 levels remains unclear...
May 2014: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Arifumi Kosakai
Immunoglobulin G4-related disease (IgG4-RD) is a novel clinical disease entity characterized by elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells. IgG4-RD can occur in various organs, including the pancreas, lacrimal gland, salivary gland, thyroid, lung, bile duct, liver, gastrointestinal tract, kidney, prostate, retroperitoneum, arteries, lymph nodes, skin, and breast. Steroid therapy is often effective. In the field of neurology, pachymeningitis (IgG4-related pachymeningitis) and hypophysitis (IgG4-related hypophysitis) are known to be related to IgG4-RD...
November 2013: Brain and Nerve, Shinkei Kenkyū No Shinpo
Zachary S Wallace, Mollie N Carruthers, Arezou Khosroshahi, Robert Carruthers, Shweta Shinagare, Anat Stemmer-Rachamimov, Vikram Deshpande, John H Stone
Hypertrophic pachymeningitis (HP) is an inflammatory condition in which the dura mater of the cranium or spine becomes thickened, leading to symptoms that result from mass effect, nerve compression, or vascular compromise. The differential diagnosis of HP includes immune-mediated conditions such as rheumatoid arthritis and vasculitis, malignancies, and infections. Many times, no diagnosis is reached; in such cases, the disease has been described as idiopathic HP. IgG4-related disease (IgG4-RD) is a recently described inflammatory condition known to cause tumefactive lesions at myriad anatomical locations...
July 2013: Medicine (Baltimore)
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