原標(biāo)題：IgG4相關(guān)疾病中的過(guò)敏  
　?、?IgG4相關(guān)疾病(IgG4-RD)是一種全身性疾病，其特點(diǎn)是血清IgG4濃度升高，多個(gè)病灶內(nèi)大量IgG4陽(yáng)性漿細(xì)胞浸潤(rùn)。已有報(bào)道IgG4-RD病變表現(xiàn)為T(mén)h2型細(xì)胞免疫?；颊咄ǔＳ羞^(guò)敏史和/或過(guò)敏癥狀。本研究旨在探討IgG4-RD患者的過(guò)敏反應(yīng)情況。②對(duì)富山大學(xué)附屬醫(yī)院就診的IgG4-RD患者進(jìn)行回顧性研究。根據(jù)綜合診斷標(biāo)準(zhǔn)對(duì)IgG4-RD進(jìn)行診斷。我們分析了鼻炎、支氣管哮喘的過(guò)敏病史、血清IgG4、IgE以及對(duì)16種氣傳過(guò)敏原的特異性IgE(CAP RAST)。③在67例明確診斷的IgG4-RD患者中，過(guò)敏性鼻炎20例(29.9%)，支氣管哮喘18例(26.9%)，皮膚過(guò)敏9例(13.4%)。診斷時(shí)血清IgG4 (> 135mg/dl)和IgE (> 170 U/ml)升高的病例分別占97.0%和89.4%，血清IgG4和IgE中位水平分別為485 mg/dl和500 U/ml。IgG4與IgE無(wú)顯著相關(guān)性。48例患者中存在特異性IgEs, 79%的患者對(duì)16種氣傳敏原的一種或多種特異性IgEs呈陽(yáng)性。④我們的研究表明，IgG4-RD患者表現(xiàn)出多種過(guò)敏性表現(xiàn)，表現(xiàn)為鼻炎和/或支氣管哮喘。然而，我們?cè)谶@些患者中沒(méi)有觀察到針對(duì)任何特定空氣過(guò)敏原的IgEs。進(jìn)一步分析過(guò)敏臨床表現(xiàn)可能有助于闡明IgG4-RD的發(fā)病機(jī)制。
　　延伸閱讀
JACI  
Allergy in IgG4-related disease
DOI: https://doi.org/10.1016/j.jaci.2017.12.864
Abstract  ：
Rationale
IgG4-related disease (IgG4-RD) is a systemic disorder, which is characterized by elevated serum IgG4 concentrations and infiltration of abundant IgG4 positive plasma cells in the multiple lesions. It has been reported the lesions of IgG4-RD present Th2 dominant immunity. And the patient often shows allergic history and/or symptoms. The aim of this study is to investigate allergic involvement in patients with IgG4-RD.
Methods
A retrospective study on patients with IgG4-RD in Toyama University Hospital was performed. The diagnosis of IgG4-RD was made based on the comprehensive diagnostic criteria. We analyzed allergic history of rhinitis, and bronchial asthma, serum IgG4, IgE and Specific IgEs to 16 aeroallergens (CAP RAST).
Results
Sixty-seven patients with ‘definite’ IgG4-RD were analyzed. Twenty patients (29.9%) had allergic rhinitis, 18 patients (26.9%) bronchial asthma, and 9 patients (13.4%) skin allergy in their past or present history. Serum IgG4 (> 135mg/dl) and IgE (> 170 U/ml) at the diagnosis were elevated in 97.0% and 89.4%, respectively, and the median serum levels of IgG4 and IgE were 485 mg/dl and 500 U/ml, respectively. There was no significant correlation between IgG4 and IgE. Specific IgEs were available in 48 patients, and 79% of them showed positive one or more specific IgEs to 16 aeroallergens.
Conclusions
Our study suggests that the patients with IgG4-RD show various allergic involvements, presenting rhinitis and/or bronchial asthma. However, we observed no IgEs directed against any specific aeroallergen in these patients. Further analysis of allergic manifestations might be helpful in elucidating the pathogenesis of IgG4-RD.
All Authors：Shoko Matsui, Seisuke Okazawa, Kohtaro Tokui, Kenta Kambara, Shingo Imanishi, Chihiro Taka, Tohru Yamada, Minehiko Inomata, Toshiro Miwa, Ryuji HayashiUniversity of Toyama, Toyama
　　創(chuàng)建過(guò)敏性疾病的科研、科普知識(shí)交流平臺(tái)，為過(guò)敏患者提供專(zhuān)業(yè)診斷、治療、預(yù)防的共享平臺(tái)。