Journal of Peking University(Health Sciences) ›› 2018, Vol. 50 ›› Issue (6): 1039-1043. doi: 10.19723/j.issn.1671-167X.2018.06.017

• Article • Previous Articles     Next Articles

A cross-sectional study of the clinical features and physician visit patterns at onset of immunoglobulin G4 related disease

Xing-yun ZHU1,Yan-ying LIU1,(),Xue-juan SUN2,Ping YU3,Shuang LIU4,Mei-yan FU5,Xu LIU1,Li-min REN1,Zhan-guo LI1   

  1. 1. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, China
    2. Department of Rheumatology and Immunology, The People’s Hospital of Langfang City, Langfang 065000, Hebei, China
    3. Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan 063000, Hebei, China
    4. Department of Rheumatology and Immunology, First Affiliated Hospital of Kuiming Medical University, Kunming 650032, China
    5. Department of Rheumatology and Immunology, Urumuqi Youyi Hospital, Urumuqi 830049, China
  • Online:2018-12-18 Published:2018-12-18
  • Contact: Yan-ying LIU E-mail:liuyanying20030801@msn.com

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Abstract:

Objective: To comprehend clinical features and patient’s physician visit patterns at onset of immunoglobulin G4 related disease (IgG4RD). Methods: In the study, 100 patients with IgG4RD who received treatments in the Department of Rheumatology and Immunology of Peking University People’s Hospital from Apr. 1st, 2017 to Apr. 1st, 2018 were investigated, including gender, age, height, body weight, age of onset, physician visit history, primary history and how did the disease affected their life, etc. Results: In this 100 IgG4RD cohort (57 males and 43 females), the male/female ratio was 1 :0.75, the mean age of onset was (51.51±12.9) years, and the median duration was 49 months (ranging from 4 to 231 months). The onset age of males was significantly older than that of females (P<0.01). The manifestations showed that up to 69% patients had submaxillay glands lesion, 59% patients had lacrimal glands lesion, 28% patients had pancreas involvement and 28% patients had parotid glands involvement. The females had more lacrimal glands involvement (P<0.05). 62% patients were complicated with anaphylactic disease. The primary physician visit departments concentrated upon general surgery department (19/100), oral and maxillofacial surgery department (17/100), rheumatology and immunology department (16/100), ophthalmology department (15/100) and gastroenterology department (10/100). The departments where the confirmed diagnose was made concentrated upon rheumatology department (67/100),oral and maxillofacial surgery department (16/100) and gastroenterology department (7/100). The mean diagnosis duration after 2010 was (16.96±2.163) months, significantly shorter than that before 2010, which was (113.3±11.01) months. Before the definite diagnose was made, 43% patients underwent surgeries and 12% patients had more than one time surgeries. The patients whose first-visit department was a surgery department were more likely to undergo surgeries (P<0.01). 18% patients (18/100) stated that the disease had affected their work. Conclusion: In this cohort of the IgG4RD patients, female is common and has earlier onset age than male. The major manifestations of IgG4RD are salivary glands, lacrimal glands and pancreas involvement. The common chief complains are salivary glands and lacrimal glands enlargement. Accompanied by anaphylactic disease is a marked manifestation of this disease. Delayed diagnoses are not rare, though this situation has been improved since 2010, and more attention still should be paid to the disease.

Key words: Autoimmune diseases, Immunoglobulin G, Signs and symptoms, Physicians visit pattern

CLC Number: 

  • R593.2

Figure 1

Primary symptoms of 100 IgG4 related disease patients (n=100)"

Table 1

Affected organs of 100 IgG4 related disease patients"

Organs n %
Submaxillary gland 69 69.0
Lacrimal gland 59 59.0
Pancreas 28 28.0
Parotid gland 28 28.0
Skin 24 24.0
Lymph node 22 22.0
Biliary tract 15 15.0
Retroperitoneal 11 11.0
Paranasal sinuses 11 11.0
Lung 10 10.0
Aorta 3 3.0
Prostate gland 2 2.0

Table 2

Primary visiting departments of 100 IgG4 related disease patients"

Departments n %
General surgery 19 19.0
Oral and maxillofacial surgery 17 17.0
Rheumatology and immunology 16 16.0
Ophthalmology 15 15.0
Gastroenterology 10 10.0
Otolaryngology and head neck surgery 8 8.0
Urology 3 3.0
Nephrology 3 3.0
General medicine 3 3.0
Oncology 2 2.0
Respiratory 1 1.0
Emergency 1 1.0
Dermatology 1 1.0
Liver disease 1 1.0

Table 3

Departments where the confirmed diagnosis was made of 100 IgG4 related disease patients"

Departments n %
Rheumatology and immunology 67 67.0
Oral and maxillofacial surgery 16 16.0
Gastroenterology 7 7.0
General surgery 4 4.0
Ophthalmology 2 2.0
Nephrology 1 1.0
Otolaryngology and head neck surgery 1 1.0
Respiratory 1 1.0
Infectious disease 1 1.0

Figure 2

Delay of diagnosis of 100 IgG4 related disease patients"

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