title: Comorbid diseases of IgG4-related sialadenitis in the head and neck region.
abstract: OBJECTIVE
  To further recognize the comorbid diseases of immunoglobulin G4-related sialadenitis (IgG4-RS) in the head and neck region and to observe the response of these conditions to immunomodulatory therapy.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  The symptoms of comorbid diseases and medical histories in 51 patients (24 men, 27 women; median age, 55 years) diagnosed with IgG4-RS were analyzed. Thirty-six patients received immunomodulatory therapy and were followed up for 10.4 ± 5.9 months. Computed tomography (CT) examination was performed before and after therapy.
  
  
  RESULTS
  Rhinosinusitis occurred in 58.8% patients, and manifested with the symptoms of nasal obstruction, nasal xerosis, and hyposmia. In addition, 43.1% patients had allergic rhinitis. Lymphadenopathy was identified in 74.5% patients. Lacrimal gland swelling occurred in 78.4% patients. Extraocular muscles, otologic organs, skin and superficial soft tissue, and cranial nerves were also involved. All of the lesions were relieved after immunomodulatory therapy. The Lund-Mackay scores decreased (9.6 ± 5.6 to 1.0 ± 2.2) according to CT analyses (P < .05). Mean CT volumes of the swollen lymph nodes and lacrimal glands decreased from 1.21 ± 0.61 cm(3) to 0.59 ± 0.35 cm(3) and from 2.25 ± 1.35 cm(3) to 0.70 ± 0.32 cm(3), respectively (P < .05) after treatment.
  
  
  CONCLUSIONS
  IgG4-RS could potentially develop with involvement of ocular adnexa, sinonasal cavities, ears, lymph nodes, skin and superficial soft tissue, and cranial nerves in the head and neck region. Immunomodulatory therapy could be effective in controlling both the comorbid diseases of IgG4-RS and sialadenitis of the major salivary glands.
  
  
  METHODS
  4.
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Xia
authors.initials: X
authors.lastname: Hong
authors.affiliation: Department of Oral Radiology.
authors.forename: Zhi-Peng
authors.initials: ZP
authors.lastname: Sun
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Jia-Zeng
authors.initials: JZ
authors.lastname: Su
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Cai
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Tong-Tong
authors.initials: TT
authors.lastname: Li
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Liu
authors.affiliation: Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
authors.forename: Yan-Ying
authors.initials: YY
authors.lastname: Liu
authors.affiliation: Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
authors.forename: Zhan-Guo
authors.initials: ZG
authors.lastname: Li
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Guang-Yan
authors.initials: GY
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D002648:Child; D002681:China / Q000453:epidemiology; D015897:Comorbidity / Q000639:trends; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007150:Immunohistochemistry; D008199:Lymphadenitis / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009333:Neck; D012189:Retrospective Studies; D012793:Sialadenitis / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D012852:Sinusitis / Q000175:diagnosis / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G
keywords: IgG4-related sialadenitis; comorbid diseases; head and neck; lymphadenopathy; ocular adnexa; rhinosinusitis; salivary gland