| Objective:IgG4 related disease is a disease with multiple organs and parts in the whole body,and the maxillofacial involvement is common.summarize and analyze the clinical manifestations,imaging findings,laboratory examination results and pathological characteristics of Ig G4 related diseases in maxillofacial region,and elaborate the treatment methods and prognosis,so as to provide ideas and references for clinical diagnosis and treatment.Methods:Patients diagnosed as Ig G4 related diseases in the Department of oral and maxillofacial surgery of the first hospital of Shanxi Medical University from July 2018 to October 2021 were collected.The clinical data,laboratory examination results,CT imaging examination results,histopathological results and drug treatment results of the patients were retrospectively studied.To explore the relationship between serum Ig G4and the course of disease;The effects of GCs and GCs combined with immunosuppressants on the prognosis of patients with Ig G4 and the serum Ig G4 levels of patients with different prognosis before treatment were compared.SPSS 26.0 was used for statistical analysis.Results:(1)Among the 35 patients,there were 29 males and 6 females,with an average age of 60.1±9.7 years.(2)The most common involved sites(organs)in the maxillofacial region were submandibular gland 87.5%(28/32),parotid gland 48.58%(17/35),lacrimal gland45.71%(16/35),cervical lymph node 97.14%(34/35),etc.(3)In the maxillofacial region,the main imaging manifestations were salivary gland swelling,some patients had nodular tumor like tissue in the salivary gland,and some patients only had diffuse swelling of the salivary gland.(4)Laboratory tests showed that serum Ig G4 increased by 97.14%(34/35),serum Ig G increased by 91.3%(21/23),and ESR increased by 84.38%(27/32).(5)Only 35.29%(6/17)submandibular gland and 33.33%(1/3)parotid gland biopsy specimens showed gland parenchymal fibrosis(lamellar stria),and 5%(1/20)parotid gland biopsy specimens showed phlebitis obliterans.(6)Spearman rank correlation analysis showed that the correlation coefficient was r_s=0.448,P=0.008,and there was a positive correlation between the serum Ig G4 level and the course of the disease.(7)GCs is effective for all patients,but recurrence still occurs clinically.According to Fisher’s exact probability analysis:P>0.05,at present,it cannot be considered that the overall recurrence rate of GCs and patients with GCs combined with immunosuppressants is different.(8)According to Mann-Whitney U test analysis:P>0.068,at present,it can not be considered that the serum Ig G4 levels of patients with relapse and those without relapse are different before treatment.Conclusion:(1)The patients with Ig G4-RD in the maxillofacial region were mainly middle-aged and elderly men.The common clinical manifestations were submandibular gland,parotid gland and lacrimal gland masses and lymphadenopathy;(2)In maxillofacial CT imaging,there were two typical manifestations of salivary gland nodular and diffuse enlargement;(3)The use of GCs in the treatment of Ig G4-RD can achieve good results in maxillofacial lesions. |
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