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Nobukazu Ishizaka - One of the best experts on this subject based on the ideXlab platform.
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Immunoglobulin G4 related coronary periarteritis in a patient presenting with myocardial ischemia
Human Pathology, 2012Co-Authors: Jun Tanigawa, Motomu Tsuji, Masahiro Daimon, Motonobu Murai, Takahiro Katsumata, Nobukazu IshizakaAbstract:Summary Recent studies suggest that the cardiovascular system might be a possible target of Immunoglobulin G4–related disease. Here we present a 66-year-old man who was admitted to our hospital because of chest symptoms suggestive of acute coronary syndrome. Besides luminal narrowing of the coronary arteries, marked periarterial thickening around the coronary artery was observed by computed tomography coronary angiography. Serum Immunoglobulin G4 levels of this patient were elevated (564 mg/dL). The patient underwent coronary bypass surgery. After incision of the pericardium, a glittery white-yellowish, elastic-hard periarterial mass surrounding the left circumflex artery could be seen. Histologic analysis of the biopsy specimen showed the formation of lymphoid follicles and the presence of Immunoglobulin G4–positive plasma cells; therefore, the diagnosis was Immunoglobulin G4–related coronary periarteritis accompanied by physiologically significant myocardial ischemia.
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Sarcoidosis does not belong to or overlap with Immunoglobulin G4-related diseases based on an assessment of serum Immunoglobulin G4 levels in cardiac and noncardiac sarcoidosis.
Human Pathology, 2011Co-Authors: Fumio Terasaki, Motomu Tsuji, Shun Kizawa, Shuichi Fujita, Yumiko Kanzaki, Yasushi Kitaura, Nobukazu IshizakaAbstract:Summary Although sarcoidosis may exhibit histopathologic features similar to those of a newly emerging clinical entity, Immunoglobulin G4–related sclerosing disease, sarcoidosis is currently not considered to be associated with Immunoglobulin G4–related immunoinflammation. Not many studies on this association have been reported. We investigated serum Immunoglobulin G4 levels among patients with sarcoidosis with or without cardiac involvement (cardiac sarcoidosis and non–cardiac sarcoidosis patients). The mean serum Immunoglobulin G4 level among the 65 patients with sarcoidosis was 56.8 ± 43.0 mg/dL, which did not significantly differ between patients with cardiac sarcoidosis (54 ± 48 mg/dL, n=12) and patients without cardiac sarcoidosis (58 ± 42 mg/dL; n=53). Serum level of soluble interleukin 2 receptor, a potent marker that may reflect sarcoidosis activity, was elevated in cardiac sarcoidosis (910 ± 683 U/L) and noncardiac sarcoidosis (689 ± 399 U/L) but did not significantly differ between the groups. Immunohistochemistry of cardiac or lymph node specimens from patients with cardiac sarcoidosis showed only sparse or no infiltration of Immunoglobulin G4–positive lymphocytes, in contrast to the moderate to severe infiltration of CD68-positive macrophages and CD45-positive lymphocytes. Although the number of study subjects was small, these findings collectively suggest that regardless of the presence or absence of cardiac involvement, sarcoidosis does not belong to or overlap with Immunoglobulin G4–related sclerosing disease.
Hirohiko Kakizaki - One of the best experts on this subject based on the ideXlab platform.
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Immunostaining of Immunoglobulin G4 in the Lacrimal Sac
Ocular Immunology and Inflammation, 2017Co-Authors: Yasuhiro Takahashi, Emiko Takahashi, Hiroshi Ikeda, Hirohiko KakizakiAbstract:ABSTRACTPurpose: To immunohistochemically examine the lacrimal sac walls harvested during dacryocystorhinostomy using an immunostain for Immunoglobulin G4 (IgG4).Methods: Forty-four lacrimal sac wa...
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Immunostaining of Immunoglobulin G4 in the Lacrimal Sac
Ocular Immunology and Inflammation, 2017Co-Authors: Yasuhiro Takahashi, Emiko Takahashi, Hiroshi Ikeda, Hirohiko KakizakiAbstract:Purpose: To immunohistochemically examine the lacrimal sac walls harvested during dacryocystorhinostomy using an immunostain for Immunoglobulin G4 (IgG4).Methods: Forty-four lacrimal sac walls were...
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Immunoglobulin G4-positive staining of orbital lesions in thyroid eye disease: Report of two cases.
Modern rheumatology, 2016Co-Authors: Yasuhiro Takahashi, Emiko Takahashi, Yuji Hiromatsu, Hirohiko KakizakiAbstract:We report two cases with Immunoglobulin G4 (IgG4)-positive staining of orbital lesions and thyroid eye disease (TED). Case 1 was a 63-year-old male with right upper eyelid swelling due to right lacrimal gland enlargement. Case 2 was a 49-year-old male with bilateral proptosis due to multiple orbital masses. Both the biopsied right lacrimal gland in Case 1 and the orbital masses on both sides in Case 2 showed infiltration of Immunoglobulin-G4-positive plasma cells.
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Immunoglobulin G4-positive lymphoplasmacytic infiltration in a sarcoidal eyelid mass
Modern rheumatology, 2016Co-Authors: Hyera Kang, Emiko Takahashi, Yasuhiro Takahashi, Hirohiko KakizakiAbstract:A 62-year-old woman presented with a one month history of a hard, nonmobile subcutaneous mass along the right nasojugal fold. Hematological studies showed elevated serum Immunoglobulin G4 levels. Histopathological examination of the biopsy sample disclosed Immunoglobulin G4-positive lymphoplasmacytic infiltration with a storiform fibrosis, vein occlusion, and epithelioid granulomas with necrosis. Systemic review corresponded to a sarcoidosis. Without treatment, the eyelid mass did not recur six months after the excisional biopsy.
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Bilateral optic nerve involvement in Immunoglobulin G4-related ophthalmic disease.
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2014Co-Authors: Yasuhiro Takahashi, Atsuko Kitamura, Hirohiko KakizakiAbstract:Background:To describe a presumptive case of Immunoglobulin G4–related ophthalmic disease (IgG4-ROD) with bilateral optic nerve involvement and to review the clinical features of this entity.Methods:Case report.Results:A 62-year-old man presented with bilateral blurred vision. He had a history of si
Yasuni Nakanuma - One of the best experts on this subject based on the ideXlab platform.
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pathologic significance of Immunoglobulin G4 positive plasma cells in extrahepatic cholangiocarcinoma
Human Pathology, 2012Co-Authors: Yasushi Kimura, Kenichi Harada, Yasuni NakanumaAbstract:Immunoglobulin G4-related sclerosing cholangitis is histologically characterized by the infiltration of Immunoglobulin G4-positive plasma cells and sclerosing change. Moreover, several cases of carcinoma accompanied by Immunoglobulin G4-positive cells in tissue and increased serum Immunoglobulin G4 levels have been reported, but the association between cancer-associated immunity and an Immunoglobulin G4 reaction is still unclear. In this study, we examined the infiltration of Immunoglobulin G4-positive cells in extrahepatic cholangiocarcinoma and the pathologic significance of the Immunoglobulin G4 reaction found in cancer tissues in terms of the evasion of immune surveillance by regulatory T cells. Immunohistochemistry for Immunoglobulin G4, forkhead box P3, CD4, and CD8 was performed using 68 surgical specimens from patients with extrahepatic cholangiocarcinoma, and positive cells were investigated, particularly within and around cancerous tissues. Consequently, although Immunoglobulin G4+ cells were few (average, <10 cells/high-power field) in most cases, 10 or more and 50 or more cells were found in 37% and 6% of cases, respectively. Immunoglobulin G4+ cells were predominantly found in the invasive front of carcinoma tissue. In the cases with 10 or more Immunoglobulin G4+ cells, forkhead box P3+ regulatory T cells were also distinguishable, and a positive correlation was found between the forkhead box P3+/CD4+ ratio and Immunoglobulin G4+ cell count, but few CD8+ cells invaded cancer cells (<10 cells). In conclusion, extrahepatic cholangiocarcinomas are often accompanied by the significant infiltration of Immunoglobulin G4+ cells, and the Immunoglobulin G4 reaction showed a positive and negative correlation with forkhead box P3+ and CD8+ cells, respectively, suggesting the evasion of immune surveillance associated with CD8+ cytotoxic T cells via the regulatory function of forkhead box P3+ regulatory T cells.
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Pathologic significance of Immunoglobulin G4-positive plasma cells in extrahepatic cholangiocarcinoma
Human Pathology, 2012Co-Authors: Yasushi Kimura, Kenichi Harada, Yasuni NakanumaAbstract:Summary Immunoglobulin G4–related sclerosing cholangitis is histologically characterized by the infiltration of Immunoglobulin G4–positive plasma cells and sclerosing change. Moreover, several cases of carcinoma accompanied by Immunoglobulin G4–positive cells in tissue and increased serum Immunoglobulin G4 levels have been reported, but the association between cancer-associated immunity and an Immunoglobulin G4 reaction is still unclear. In this study, we examined the infiltration of Immunoglobulin G4–positive cells in extrahepatic cholangiocarcinoma and the pathologic significance of the Immunoglobulin G4 reaction found in cancer tissues in terms of the evasion of immune surveillance by regulatory T cells. Immunohistochemistry for Immunoglobulin G4, forkhead box P3, CD4, and CD8 was performed using 68 surgical specimens from patients with extrahepatic cholangiocarcinoma, and positive cells were investigated, particularly within and around cancerous tissues. Consequently, although Immunoglobulin G4+ cells were few (average,
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Pathologic significance of Immunoglobulin G4–positive plasma cells in extrahepatic cholangiocarcinoma
Human pathology, 2012Co-Authors: Yasushi Kimura, Kenichi Harada, Yasuni NakanumaAbstract:Immunoglobulin G4-related sclerosing cholangitis is histologically characterized by the infiltration of Immunoglobulin G4-positive plasma cells and sclerosing change. Moreover, several cases of carcinoma accompanied by Immunoglobulin G4-positive cells in tissue and increased serum Immunoglobulin G4 levels have been reported, but the association between cancer-associated immunity and an Immunoglobulin G4 reaction is still unclear. In this study, we examined the infiltration of Immunoglobulin G4-positive cells in extrahepatic cholangiocarcinoma and the pathologic significance of the Immunoglobulin G4 reaction found in cancer tissues in terms of the evasion of immune surveillance by regulatory T cells. Immunohistochemistry for Immunoglobulin G4, forkhead box P3, CD4, and CD8 was performed using 68 surgical specimens from patients with extrahepatic cholangiocarcinoma, and positive cells were investigated, particularly within and around cancerous tissues. Consequently, although Immunoglobulin G4+ cells were few (average,
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Immunoglobulin G4 related periaortitis and periarteritis ct findings in 17 patients
Radiology, 2011Co-Authors: Dai Inoue, Yasuni Nakanuma, Yoh Zen, Hitoshi Abo, Toshifumi Gabata, Hiroshi Demachi, J Yoshikawa, Shiro Miyayama, Osamu MatsuiAbstract:Immunoglobulin G4 (IgG4)-related arterial lesions occur mainly in the aorta and its main branches and are radiologically characterized by homogeneous arterial wall thickening and enhancement at late phase contrast-enhanced CT, which represent histological features of IgG4-related sclerosing inflammation predominantly involving the adventitia.
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Immunoglobulin G4–related Periaortitis and Periarteritis: CT Findings in 17 Patients
Radiology, 2011Co-Authors: Dai Inoue, Yasuni Nakanuma, Yoh Zen, Hitoshi Abo, Toshifumi Gabata, Hiroshi Demachi, J Yoshikawa, Shiro Miyayama, Osamu MatsuiAbstract:Immunoglobulin G4 (IgG4)-related arterial lesions occur mainly in the aorta and its main branches and are radiologically characterized by homogeneous arterial wall thickening and enhancement at late phase contrast-enhanced CT, which represent histological features of IgG4-related sclerosing inflammation predominantly involving the adventitia.
Audrey B. Erman - One of the best experts on this subject based on the ideXlab platform.
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Immunoglobulin G4-related sclerosing disease Mimicking sjogren's syndrome: A case report.
The Laryngoscope, 2016Co-Authors: Hilary C. Mccrary, Erynne A. Faucett, Audrey B. ErmanAbstract:Immunoglobulin G4-related sclerosing disease (IgG4-RSD) is a fibroinflammatory condition that has the potential to affect nearly every organ system. Classic histological findings include storiform fibrosis and lymphoplasmacytic infiltrates of Immunoglobulin G4 (IgG4)-positive plasma cells. The clinical features of IgG4-RSD may be an under-recognized disease process that can mimic other autoimmune disorders, including Sjogren's syndrome. We describe a rare case of IgG4-RSD involving the salivary glands, initially misdiagnosed as Sjogren's syndrome. Clinical features of IgG4-RSD can mimic those of other autoimmune disorders affecting the head and neck. Therefore, otolaryngologists should have IgG4-RSD on their differential when evaluating patients with diffuse salivary gland swelling. Laryngoscope, 126:2242-2245, 2016.
Yasuhiro Takahashi - One of the best experts on this subject based on the ideXlab platform.
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Immunostaining of Immunoglobulin G4 in the Lacrimal Sac
Ocular Immunology and Inflammation, 2017Co-Authors: Yasuhiro Takahashi, Emiko Takahashi, Hiroshi Ikeda, Hirohiko KakizakiAbstract:ABSTRACTPurpose: To immunohistochemically examine the lacrimal sac walls harvested during dacryocystorhinostomy using an immunostain for Immunoglobulin G4 (IgG4).Methods: Forty-four lacrimal sac wa...
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Immunostaining of Immunoglobulin G4 in the Lacrimal Sac
Ocular Immunology and Inflammation, 2017Co-Authors: Yasuhiro Takahashi, Emiko Takahashi, Hiroshi Ikeda, Hirohiko KakizakiAbstract:Purpose: To immunohistochemically examine the lacrimal sac walls harvested during dacryocystorhinostomy using an immunostain for Immunoglobulin G4 (IgG4).Methods: Forty-four lacrimal sac walls were...
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Immunoglobulin G4-positive staining of orbital lesions in thyroid eye disease: Report of two cases.
Modern rheumatology, 2016Co-Authors: Yasuhiro Takahashi, Emiko Takahashi, Yuji Hiromatsu, Hirohiko KakizakiAbstract:We report two cases with Immunoglobulin G4 (IgG4)-positive staining of orbital lesions and thyroid eye disease (TED). Case 1 was a 63-year-old male with right upper eyelid swelling due to right lacrimal gland enlargement. Case 2 was a 49-year-old male with bilateral proptosis due to multiple orbital masses. Both the biopsied right lacrimal gland in Case 1 and the orbital masses on both sides in Case 2 showed infiltration of Immunoglobulin-G4-positive plasma cells.
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Immunoglobulin G4-positive lymphoplasmacytic infiltration in a sarcoidal eyelid mass
Modern rheumatology, 2016Co-Authors: Hyera Kang, Emiko Takahashi, Yasuhiro Takahashi, Hirohiko KakizakiAbstract:A 62-year-old woman presented with a one month history of a hard, nonmobile subcutaneous mass along the right nasojugal fold. Hematological studies showed elevated serum Immunoglobulin G4 levels. Histopathological examination of the biopsy sample disclosed Immunoglobulin G4-positive lymphoplasmacytic infiltration with a storiform fibrosis, vein occlusion, and epithelioid granulomas with necrosis. Systemic review corresponded to a sarcoidosis. Without treatment, the eyelid mass did not recur six months after the excisional biopsy.
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Bilateral optic nerve involvement in Immunoglobulin G4-related ophthalmic disease.
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2014Co-Authors: Yasuhiro Takahashi, Atsuko Kitamura, Hirohiko KakizakiAbstract:Background:To describe a presumptive case of Immunoglobulin G4–related ophthalmic disease (IgG4-ROD) with bilateral optic nerve involvement and to review the clinical features of this entity.Methods:Case report.Results:A 62-year-old man presented with bilateral blurred vision. He had a history of si