title: IgG4-related chronic rhinosinusitis: a new clinical entity of nasal disease.
abstract: CONCLUSIONS
  IgG4-related disease involves nasal manifestations with chronic rhinosinusitis (CRS). This type of sinusitis is a new clinical entity of nasal disease associated with a high level of serum IgG4 for which steroid therapy is effective. Objectives. To confirm whether IgG4-related disease has distinctive chronic rhinosinusitis.
  
  
  METHODS
  We compared serum IgG4 levels as well as nasal computed tomography (CT) and clinicopathological findings before and after glucocorticoid treatment in 31 patients diagnosed as having IgG4-related disease with nasal manifestations. To evaluate immunohistochemical findings of nasal mucosa, we compared them with IgG4-related CRS and common CRS.
  
  
  RESULTS
  All patients had levels of high serum IgG4. Ten of the 31 patients had nasal obstruction, nasal discharge, postnasal discharge, hyposmia, and dull headache. They also demonstrated sinus lesions on radiological findings. After glucocorticoid treatment, serum IgG and IgG4 levels were markedly decreased and along with improvement of the symptoms, nasal sinus CT findings also revealed improvement of the sinus opacification. In immunohistochemical examination, the magnitude of IgG4-positive plasma cell infiltration in common CRS was almost the same as in the IgG4-related CRS group. Therefore, in nasal mucosa immunocytochemical positive staining for IgG4 is not specific for definition of IgG4-related disease.
authors.affiliation: Department of Otorhinolaryngology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Moteki
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuo
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hamano
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uehara
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Usami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D008882:Mikulicz' Disease / Q000150:complications; D010195:Pancreatitis / Q000150:complications; D010256:Paranasal Sinuses / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use; D012220:Rhinitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012852:Sinusitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D005938:Glucocorticoids; D007074:Immunoglobulin G; D011239:Prednisolone