IgG4相关性心包炎的临床研究

Clinical study of Immunoglobulin G4-related pericarditis

目的通过报道少见的IgG4相关性心包炎并进行文献复习,分析该病的临床表现和预后。方法报道一例IgG4相关性心包炎,并以"IgG4"和"pericarditis"检索Pub Med进行文献复习。结果本例患者经过临床表现、血清学检查和影像学检查,确诊为IgG4相关性心包炎。IgG4相关性心包炎的临床表现多样,多数经手术病理确诊,对激素治疗反应良好。结论本病临床少见,遇到有心包炎临床特征的患者,可行IgG4血清学检测及其他相关腺体疾病筛查,如合并自身免疫相关性疾病应考虑本病可能,早发现,早诊断,早期糖皮质激素治疗可避免手术治疗。

Objective By reporting rare immunoglobulin G4 （ IgG4 ） related pericarditis and reviewing the literature, the clinical manifestation and prognosis of this disease were studied. Methods One case of IgG4-associated pericarditis was reported and ＂IgG4＂ and ＂pericarditis＂ were searched in PubMed, the corresponding literature related pericarditis were retrospectively analyzed. Results Pericarditis caused by IgG4-related disease is not easy to diagnosis after the clinical physical examination and imaging examination,the diagnosis of the disease can be mostly confirmed by surgery and pathology or its good response to the hormone therapy. Conclusions Pericarditis caused by IgG4-related disease is a rare clinical disease. When encountered the patients with clinical features of pericardial inflammation,the possibility of this disease should be considered. Screening serum IgG4 level and other related diseases such as autoimmune pancreatitis should be helpful. As soon as the diagnosis of the IgG4 associated pericarditis, early treatment with corticosteroids may avoid surgery.