The Experts below are selected from a list of 480 Experts worldwide ranked by ideXlab platform

Shigeyuki Kawa - One of the best experts on this subject based on the ideXlab platform.

  • clinical features of igg4 related periaortitis Periarteritis based on the analysis of 179 patients with igg4 related disease a case control study
    Arthritis Research & Therapy, 2017
    Co-Authors: Makiko Ozawa, Yasunari Fujinaga, Junpei Asano, Akira Nakamura, Takayuki Watanabe, Tetsuya Ito, Takashi Muraki, Hideaki Hamano, Shigeyuki Kawa
    Abstract:

    Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic condition characterized by high serum immunoglobulin G4 (IgG4) concentration and IgG4-bearing plasma cell infiltration in affected organs. Although it has become evident that IgG4-RD also involves the systemic aortic/arterial system, the precise details of this condition remain unclear. The present study sought to clarify the clinical features of IgG4-related periaortitis/Periarteritis. Among 223 patients with IgG4-RD, 179 (131 male, median onset age 67 years) were recruited for this study. Periaortitis/Periarteritis was defined as vessel wall thickness with circumferential enhancement on contrast-enhanced computed tomography. Periaortitis/Periarteritis was identified in 65 (36.3%; 53 male) of 179 IgG-RD patients. The distribution of IgG4-related periaortitis/Periarteritis could be broadly classified into five types, with the most prevalent Type 2 (44.6%) being localized at the infra-renal artery portion of the abdominal aorta and continuing to the iliac arteries. The infra-renal artery region of the abdominal aorta was most frequently involved (>80%) among IgG4-related periaortitis/Periarteritis cases. Comparisons of clinical parameters between IgG4-RD patients with and without periaortitis/Periarteritis revealed significantly higher propensities for older IgG4-RD onset age and highly active disease state featuring elevated serum IgG, IgG4, circulating immune complex, and soluble interleukin-2 receptor. All patients showed improvement of wall thickening after steroid therapy, although nine patients (20.9%) exhibited worsening of luminal dilatation. The main risk factor for this manifestation was prior luminal dilatation according to multivariate analysis. IgG4-related periaortitis/Periarteritis predominantly occurred at the infra-renal artery portion of the abdominal aorta, affected older IgG4-RD onset patients, and was prevalent in highly active disease states. As reported previously, the main risk factor for worsening luminal dilation after corticosteroid therapy was the existence of luminal dilation beforehand.

  • Clinical features of IgG4-related periaortitis/Periarteritis based on the analysis of 179 patients with IgG4-related disease: a case–control study
    'Springer Science and Business Media LLC', 2017
    Co-Authors: Makiko Ozawa, Yasunari Fujinaga, Junpei Asano, Akira Nakamura, Takayuki Watanabe, Tetsuya Ito, Takashi Muraki, Hideaki Hamano, Shigeyuki Kawa
    Abstract:

    Abstract Background Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic condition characterized by high serum immunoglobulin G4 (IgG4) concentration and IgG4-bearing plasma cell infiltration in affected organs. Although it has become evident that IgG4-RD also involves the systemic aortic/arterial system, the precise details of this condition remain unclear. The present study sought to clarify the clinical features of IgG4-related periaortitis/Periarteritis. Methods Among 223 patients with IgG4-RD, 179 (131 male, median onset age 67 years) were recruited for this study. Periaortitis/Periarteritis was defined as vessel wall thickness with circumferential enhancement on contrast-enhanced computed tomography. Results Periaortitis/Periarteritis was identified in 65 (36.3%; 53 male) of 179 IgG-RD patients. The distribution of IgG4-related periaortitis/Periarteritis could be broadly classified into five types, with the most prevalent Type 2 (44.6%) being localized at the infra-renal artery portion of the abdominal aorta and continuing to the iliac arteries. The infra-renal artery region of the abdominal aorta was most frequently involved (>80%) among IgG4-related periaortitis/Periarteritis cases. Comparisons of clinical parameters between IgG4-RD patients with and without periaortitis/Periarteritis revealed significantly higher propensities for older IgG4-RD onset age and highly active disease state featuring elevated serum IgG, IgG4, circulating immune complex, and soluble interleukin-2 receptor. All patients showed improvement of wall thickening after steroid therapy, although nine patients (20.9%) exhibited worsening of luminal dilatation. The main risk factor for this manifestation was prior luminal dilatation according to multivariate analysis. Conclusion IgG4-related periaortitis/Periarteritis predominantly occurred at the infra-renal artery portion of the abdominal aorta, affected older IgG4-RD onset patients, and was prevalent in highly active disease states. As reported previously, the main risk factor for worsening luminal dilation after corticosteroid therapy was the existence of luminal dilation beforehand

Satomi Kasashima - One of the best experts on this subject based on the ideXlab platform.

  • clinical and pathological characteristics of igg4 related periaortitis Periarteritis and retroperitoneal fibrosis diagnosed based on experts diagnosis
    Annals of Vascular Diseases, 2019
    Co-Authors: Ichiro Mizushima, Yoh Zen, Dai Inoue, Satomi Kasashima, Yasunari Fujinaga, Kenji Notohara, Takako Saeki, Motohisa Yamamoto, Fuminari Kasashima, Yasushi Matsumoto
    Abstract:

    IgG4-related disease is a systemic disease, characterized by elevation of serum IgG4 and, histopathologically, massive infiltration of IgG4+ lymphocyte and plasma cell infiltration, storiform fibrosis, causing enlargement, nodules or thickening. It may affect various organs simultaneously or metachronously. Here we analyzed the clinical and pathological characteristics of 99 patients diagnosed with IgG4-related periaortitis/Periarteritis and retroperitoneal fibrosis. Of 99 patients (women/men, 15/84; mean age 67.3±9.5 years), 33 were diagnosed based on the histopathological findings of perivascular/retroperitoneal lesions, 50 were diagnosed based on the characteristic imaging findings of perivascular/retroperitoneal lesions and the presence of definitive IgG4-related disease in other organ(s), and the remaining 16 patients were diagnosed by experts based on the characteristic imaging findings of perivascular/retroperitoneal legions, serological findings, response to glucocorticoid treatment, and/or the presence of suspected IgG4-related disease in other organ(s). According to the new organ-specific criteria proposed by experts, 73 (73.7%) diagnoses were categorized to be definitive, and 6 (6.1%) and 17 (17.2%) diagnoses were categorized to be probable and possible, respectively. Further analyses are needed to clarify the optimal diagnostic and therapeutic strategy of IgG4-related periaortitis/Periarteritis and retroperitoneal fibrosis. (This is a translation of J Jpn Coll Angiol 2018; 58: 117-129.).

  • clinical course after corticosteroid therapy in igg4 related aortitis periaortitis and Periarteritis a retrospective multicenter study
    Arthritis Research & Therapy, 2014
    Co-Authors: Ichiro Mizushima, Dai Inoue, Takako Saeki, Motohisa Yamamoto, Kazunori Yamada, Yoshifumi Ubara, Shoko Matsui, Yasufumi Masaki, Takashi Wada, Satomi Kasashima
    Abstract:

    Introduction: Immunoglobulin G4 (IgG4)–related aortitis/periaortitis and Periarteritis are vascular manifestations of IgG4-related disease. In this disease, the affected aneurysmal lesion has been suspected to be at risk of rupture. In this study, we aimed to clarify the clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and Periarteritis. Methods: We retrospectively evaluated clinical features, including laboratory data, imaging findings and the course after corticosteroid therapy, in 40 patients diagnosed with IgG4-related aortitis/periaortitis and Periarteritis on the basis of periaortic/periarterial radiological findings, satisfaction of the comprehensive diagnostic criteria or each organ-specific diagnostic criteria, and exclusion of other diseases. Results: The patients were mainly elderly, with an average age of 66.4 years and with a marked male predominance and extensive other organ involvement. Subjective symptoms were scanty, and only a small proportion had elevated serum C-reactive protein levels. The affected aorta/artery were the abdominal aortas or the iliac arteries in most cases. Thirty-six patients were treated with prednisolone, and the periaortic/periarterial lesions improved in most of them during the follow-up period. Two (50.0%) of four patients with luminal dilatation of the affected lesions before corticosteroid therapy had exacerbations of luminal dilatation after therapy, whereas none of the twenty-six patients without it had a new appearance of luminal dilatation after therapy. Conclusions: The results of this retrospective multicenter study highlight three important points: (1) the possibility of latent existence and progression of periaortic/periarterial lesions, (2) th ee fficacy of corticosteroid therapy in preventing new aneurysm formation in patients without luminal dilatation of periaortic/periarterial lesions and (3) the possibility that a small proportion of patients may actually develop luminal dilatation of periaortic/periarterial lesions in IgG4-related aortitis/periaortitis and Periarteritis. A larger-scale prospective study is required to confirm the efficacy and safety of corticosteroid therapy in patients with versus those without luminal dilatation and to devise a more useful and safe treatment strategy, including administration of other immunosuppressants.

Ichiro Mizushima - One of the best experts on this subject based on the ideXlab platform.

  • clinical and pathological characteristics of igg4 related periaortitis Periarteritis and retroperitoneal fibrosis diagnosed based on experts diagnosis
    Annals of Vascular Diseases, 2019
    Co-Authors: Ichiro Mizushima, Yoh Zen, Dai Inoue, Satomi Kasashima, Yasunari Fujinaga, Kenji Notohara, Takako Saeki, Motohisa Yamamoto, Fuminari Kasashima, Yasushi Matsumoto
    Abstract:

    IgG4-related disease is a systemic disease, characterized by elevation of serum IgG4 and, histopathologically, massive infiltration of IgG4+ lymphocyte and plasma cell infiltration, storiform fibrosis, causing enlargement, nodules or thickening. It may affect various organs simultaneously or metachronously. Here we analyzed the clinical and pathological characteristics of 99 patients diagnosed with IgG4-related periaortitis/Periarteritis and retroperitoneal fibrosis. Of 99 patients (women/men, 15/84; mean age 67.3±9.5 years), 33 were diagnosed based on the histopathological findings of perivascular/retroperitoneal lesions, 50 were diagnosed based on the characteristic imaging findings of perivascular/retroperitoneal lesions and the presence of definitive IgG4-related disease in other organ(s), and the remaining 16 patients were diagnosed by experts based on the characteristic imaging findings of perivascular/retroperitoneal legions, serological findings, response to glucocorticoid treatment, and/or the presence of suspected IgG4-related disease in other organ(s). According to the new organ-specific criteria proposed by experts, 73 (73.7%) diagnoses were categorized to be definitive, and 6 (6.1%) and 17 (17.2%) diagnoses were categorized to be probable and possible, respectively. Further analyses are needed to clarify the optimal diagnostic and therapeutic strategy of IgG4-related periaortitis/Periarteritis and retroperitoneal fibrosis. (This is a translation of J Jpn Coll Angiol 2018; 58: 117-129.).

  • clinical course after corticosteroid therapy in igg4 related aortitis periaortitis and Periarteritis a retrospective multicenter study
    Arthritis Research & Therapy, 2014
    Co-Authors: Ichiro Mizushima, Dai Inoue, Takako Saeki, Motohisa Yamamoto, Kazunori Yamada, Yoshifumi Ubara, Shoko Matsui, Yasufumi Masaki, Takashi Wada, Satomi Kasashima
    Abstract:

    Introduction: Immunoglobulin G4 (IgG4)–related aortitis/periaortitis and Periarteritis are vascular manifestations of IgG4-related disease. In this disease, the affected aneurysmal lesion has been suspected to be at risk of rupture. In this study, we aimed to clarify the clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and Periarteritis. Methods: We retrospectively evaluated clinical features, including laboratory data, imaging findings and the course after corticosteroid therapy, in 40 patients diagnosed with IgG4-related aortitis/periaortitis and Periarteritis on the basis of periaortic/periarterial radiological findings, satisfaction of the comprehensive diagnostic criteria or each organ-specific diagnostic criteria, and exclusion of other diseases. Results: The patients were mainly elderly, with an average age of 66.4 years and with a marked male predominance and extensive other organ involvement. Subjective symptoms were scanty, and only a small proportion had elevated serum C-reactive protein levels. The affected aorta/artery were the abdominal aortas or the iliac arteries in most cases. Thirty-six patients were treated with prednisolone, and the periaortic/periarterial lesions improved in most of them during the follow-up period. Two (50.0%) of four patients with luminal dilatation of the affected lesions before corticosteroid therapy had exacerbations of luminal dilatation after therapy, whereas none of the twenty-six patients without it had a new appearance of luminal dilatation after therapy. Conclusions: The results of this retrospective multicenter study highlight three important points: (1) the possibility of latent existence and progression of periaortic/periarterial lesions, (2) th ee fficacy of corticosteroid therapy in preventing new aneurysm formation in patients without luminal dilatation of periaortic/periarterial lesions and (3) the possibility that a small proportion of patients may actually develop luminal dilatation of periaortic/periarterial lesions in IgG4-related aortitis/periaortitis and Periarteritis. A larger-scale prospective study is required to confirm the efficacy and safety of corticosteroid therapy in patients with versus those without luminal dilatation and to devise a more useful and safe treatment strategy, including administration of other immunosuppressants.

Makiko Ozawa - One of the best experts on this subject based on the ideXlab platform.

  • clinical features of igg4 related periaortitis Periarteritis based on the analysis of 179 patients with igg4 related disease a case control study
    Arthritis Research & Therapy, 2017
    Co-Authors: Makiko Ozawa, Yasunari Fujinaga, Junpei Asano, Akira Nakamura, Takayuki Watanabe, Tetsuya Ito, Takashi Muraki, Hideaki Hamano, Shigeyuki Kawa
    Abstract:

    Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic condition characterized by high serum immunoglobulin G4 (IgG4) concentration and IgG4-bearing plasma cell infiltration in affected organs. Although it has become evident that IgG4-RD also involves the systemic aortic/arterial system, the precise details of this condition remain unclear. The present study sought to clarify the clinical features of IgG4-related periaortitis/Periarteritis. Among 223 patients with IgG4-RD, 179 (131 male, median onset age 67 years) were recruited for this study. Periaortitis/Periarteritis was defined as vessel wall thickness with circumferential enhancement on contrast-enhanced computed tomography. Periaortitis/Periarteritis was identified in 65 (36.3%; 53 male) of 179 IgG-RD patients. The distribution of IgG4-related periaortitis/Periarteritis could be broadly classified into five types, with the most prevalent Type 2 (44.6%) being localized at the infra-renal artery portion of the abdominal aorta and continuing to the iliac arteries. The infra-renal artery region of the abdominal aorta was most frequently involved (>80%) among IgG4-related periaortitis/Periarteritis cases. Comparisons of clinical parameters between IgG4-RD patients with and without periaortitis/Periarteritis revealed significantly higher propensities for older IgG4-RD onset age and highly active disease state featuring elevated serum IgG, IgG4, circulating immune complex, and soluble interleukin-2 receptor. All patients showed improvement of wall thickening after steroid therapy, although nine patients (20.9%) exhibited worsening of luminal dilatation. The main risk factor for this manifestation was prior luminal dilatation according to multivariate analysis. IgG4-related periaortitis/Periarteritis predominantly occurred at the infra-renal artery portion of the abdominal aorta, affected older IgG4-RD onset patients, and was prevalent in highly active disease states. As reported previously, the main risk factor for worsening luminal dilation after corticosteroid therapy was the existence of luminal dilation beforehand.

  • Clinical features of IgG4-related periaortitis/Periarteritis based on the analysis of 179 patients with IgG4-related disease: a case–control study
    'Springer Science and Business Media LLC', 2017
    Co-Authors: Makiko Ozawa, Yasunari Fujinaga, Junpei Asano, Akira Nakamura, Takayuki Watanabe, Tetsuya Ito, Takashi Muraki, Hideaki Hamano, Shigeyuki Kawa
    Abstract:

    Abstract Background Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic condition characterized by high serum immunoglobulin G4 (IgG4) concentration and IgG4-bearing plasma cell infiltration in affected organs. Although it has become evident that IgG4-RD also involves the systemic aortic/arterial system, the precise details of this condition remain unclear. The present study sought to clarify the clinical features of IgG4-related periaortitis/Periarteritis. Methods Among 223 patients with IgG4-RD, 179 (131 male, median onset age 67 years) were recruited for this study. Periaortitis/Periarteritis was defined as vessel wall thickness with circumferential enhancement on contrast-enhanced computed tomography. Results Periaortitis/Periarteritis was identified in 65 (36.3%; 53 male) of 179 IgG-RD patients. The distribution of IgG4-related periaortitis/Periarteritis could be broadly classified into five types, with the most prevalent Type 2 (44.6%) being localized at the infra-renal artery portion of the abdominal aorta and continuing to the iliac arteries. The infra-renal artery region of the abdominal aorta was most frequently involved (>80%) among IgG4-related periaortitis/Periarteritis cases. Comparisons of clinical parameters between IgG4-RD patients with and without periaortitis/Periarteritis revealed significantly higher propensities for older IgG4-RD onset age and highly active disease state featuring elevated serum IgG, IgG4, circulating immune complex, and soluble interleukin-2 receptor. All patients showed improvement of wall thickening after steroid therapy, although nine patients (20.9%) exhibited worsening of luminal dilatation. The main risk factor for this manifestation was prior luminal dilatation according to multivariate analysis. Conclusion IgG4-related periaortitis/Periarteritis predominantly occurred at the infra-renal artery portion of the abdominal aorta, affected older IgG4-RD onset patients, and was prevalent in highly active disease states. As reported previously, the main risk factor for worsening luminal dilation after corticosteroid therapy was the existence of luminal dilation beforehand

Yasunari Fujinaga - One of the best experts on this subject based on the ideXlab platform.

  • clinical and pathological characteristics of igg4 related periaortitis Periarteritis and retroperitoneal fibrosis diagnosed based on experts diagnosis
    Annals of Vascular Diseases, 2019
    Co-Authors: Ichiro Mizushima, Yoh Zen, Dai Inoue, Satomi Kasashima, Yasunari Fujinaga, Kenji Notohara, Takako Saeki, Motohisa Yamamoto, Fuminari Kasashima, Yasushi Matsumoto
    Abstract:

    IgG4-related disease is a systemic disease, characterized by elevation of serum IgG4 and, histopathologically, massive infiltration of IgG4+ lymphocyte and plasma cell infiltration, storiform fibrosis, causing enlargement, nodules or thickening. It may affect various organs simultaneously or metachronously. Here we analyzed the clinical and pathological characteristics of 99 patients diagnosed with IgG4-related periaortitis/Periarteritis and retroperitoneal fibrosis. Of 99 patients (women/men, 15/84; mean age 67.3±9.5 years), 33 were diagnosed based on the histopathological findings of perivascular/retroperitoneal lesions, 50 were diagnosed based on the characteristic imaging findings of perivascular/retroperitoneal lesions and the presence of definitive IgG4-related disease in other organ(s), and the remaining 16 patients were diagnosed by experts based on the characteristic imaging findings of perivascular/retroperitoneal legions, serological findings, response to glucocorticoid treatment, and/or the presence of suspected IgG4-related disease in other organ(s). According to the new organ-specific criteria proposed by experts, 73 (73.7%) diagnoses were categorized to be definitive, and 6 (6.1%) and 17 (17.2%) diagnoses were categorized to be probable and possible, respectively. Further analyses are needed to clarify the optimal diagnostic and therapeutic strategy of IgG4-related periaortitis/Periarteritis and retroperitoneal fibrosis. (This is a translation of J Jpn Coll Angiol 2018; 58: 117-129.).

  • clinical features of igg4 related periaortitis Periarteritis based on the analysis of 179 patients with igg4 related disease a case control study
    Arthritis Research & Therapy, 2017
    Co-Authors: Makiko Ozawa, Yasunari Fujinaga, Junpei Asano, Akira Nakamura, Takayuki Watanabe, Tetsuya Ito, Takashi Muraki, Hideaki Hamano, Shigeyuki Kawa
    Abstract:

    Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic condition characterized by high serum immunoglobulin G4 (IgG4) concentration and IgG4-bearing plasma cell infiltration in affected organs. Although it has become evident that IgG4-RD also involves the systemic aortic/arterial system, the precise details of this condition remain unclear. The present study sought to clarify the clinical features of IgG4-related periaortitis/Periarteritis. Among 223 patients with IgG4-RD, 179 (131 male, median onset age 67 years) were recruited for this study. Periaortitis/Periarteritis was defined as vessel wall thickness with circumferential enhancement on contrast-enhanced computed tomography. Periaortitis/Periarteritis was identified in 65 (36.3%; 53 male) of 179 IgG-RD patients. The distribution of IgG4-related periaortitis/Periarteritis could be broadly classified into five types, with the most prevalent Type 2 (44.6%) being localized at the infra-renal artery portion of the abdominal aorta and continuing to the iliac arteries. The infra-renal artery region of the abdominal aorta was most frequently involved (>80%) among IgG4-related periaortitis/Periarteritis cases. Comparisons of clinical parameters between IgG4-RD patients with and without periaortitis/Periarteritis revealed significantly higher propensities for older IgG4-RD onset age and highly active disease state featuring elevated serum IgG, IgG4, circulating immune complex, and soluble interleukin-2 receptor. All patients showed improvement of wall thickening after steroid therapy, although nine patients (20.9%) exhibited worsening of luminal dilatation. The main risk factor for this manifestation was prior luminal dilatation according to multivariate analysis. IgG4-related periaortitis/Periarteritis predominantly occurred at the infra-renal artery portion of the abdominal aorta, affected older IgG4-RD onset patients, and was prevalent in highly active disease states. As reported previously, the main risk factor for worsening luminal dilation after corticosteroid therapy was the existence of luminal dilation beforehand.

  • Clinical features of IgG4-related periaortitis/Periarteritis based on the analysis of 179 patients with IgG4-related disease: a case–control study
    'Springer Science and Business Media LLC', 2017
    Co-Authors: Makiko Ozawa, Yasunari Fujinaga, Junpei Asano, Akira Nakamura, Takayuki Watanabe, Tetsuya Ito, Takashi Muraki, Hideaki Hamano, Shigeyuki Kawa
    Abstract:

    Abstract Background Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic condition characterized by high serum immunoglobulin G4 (IgG4) concentration and IgG4-bearing plasma cell infiltration in affected organs. Although it has become evident that IgG4-RD also involves the systemic aortic/arterial system, the precise details of this condition remain unclear. The present study sought to clarify the clinical features of IgG4-related periaortitis/Periarteritis. Methods Among 223 patients with IgG4-RD, 179 (131 male, median onset age 67 years) were recruited for this study. Periaortitis/Periarteritis was defined as vessel wall thickness with circumferential enhancement on contrast-enhanced computed tomography. Results Periaortitis/Periarteritis was identified in 65 (36.3%; 53 male) of 179 IgG-RD patients. The distribution of IgG4-related periaortitis/Periarteritis could be broadly classified into five types, with the most prevalent Type 2 (44.6%) being localized at the infra-renal artery portion of the abdominal aorta and continuing to the iliac arteries. The infra-renal artery region of the abdominal aorta was most frequently involved (>80%) among IgG4-related periaortitis/Periarteritis cases. Comparisons of clinical parameters between IgG4-RD patients with and without periaortitis/Periarteritis revealed significantly higher propensities for older IgG4-RD onset age and highly active disease state featuring elevated serum IgG, IgG4, circulating immune complex, and soluble interleukin-2 receptor. All patients showed improvement of wall thickening after steroid therapy, although nine patients (20.9%) exhibited worsening of luminal dilatation. The main risk factor for this manifestation was prior luminal dilatation according to multivariate analysis. Conclusion IgG4-related periaortitis/Periarteritis predominantly occurred at the infra-renal artery portion of the abdominal aorta, affected older IgG4-RD onset patients, and was prevalent in highly active disease states. As reported previously, the main risk factor for worsening luminal dilation after corticosteroid therapy was the existence of luminal dilation beforehand