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Clinical Rheumatology

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18.07.2021 | Original Article

Natural developing process of immunoglobulin G4-related sialadenitis after submandibular gland excision: a retrospective cohort study

verfasst von: Ke-Fu Zhang, Xia Hong, Wei Li, Yan Gao, Yan Chen, Yan-Yan Zhang, Jia-Zeng Su, Xin Peng, Guang-Yan Yu

Erschienen in: Clinical Rheumatology | Ausgabe 12/2021

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Abstract

Objective

This study aimed to evaluate the long-term outcome and quality of life of IgG4-related sialadenitis (IgG4-RS) patients after submandibular gland (SMG) excision without immunomediate therapy.

Materials and methods

This retrospective review included patients with IgG4-RS who did not undergo further treatment following SMG excision. All patients diagnosed with IgG4-RS between January 1955 and December 2012 at the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, were enrolled. The main outcome measures included postoperative IgG4-RS progression rate and differences between patients with and without recurrent disease. The degree of subjective oral dryness was evaluated using the summated xerostomia inventory (SXI); the objective secretory function was assessed by whole saliva flow rate measurements. Serological findings were analyzed during the follow-up.

Results

SMG excision was adopted in all of the 83 patients. The median follow-up period was 108 (range 7–396) months. Clinical progression was observed in 54.2% of cases. Patients with other organ involvement (OOI) indicated higher progression rate to a significant extent (P = 0.015, HR = 2.108). The annual progression rate was 20.7% in the group with OOI and was 14.1% in the group without OOI. All cases showed higher levels of serum IgG4; the level was in positive correlation with follow-up time when no therapy was added. 82.4% of cases experienced xerostomia after the surgery, and the degree of dry mouth in patients underwent bilateral resection was significantly more severe than those in unilateral resection.

Conclusions

Surgical excision of involved SMG cannot control the disease progression, which is not recommended for treatment of IgG4-RS. Differential diagnosis is crucial in order to prevent irreversible organ loss and relevant salivary gland dysfunction.

Key Points

• Surgical excision of involved SMG cannot control progression of IgG4-RS.

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Titel: Natural developing process of immunoglobulin G4-related sialadenitis after submandibular gland excision: a retrospective cohort study
verfasst von: Ke-Fu Zhang
Xia Hong
Wei Li
Yan Gao
Yan Chen
Yan-Yan Zhang
Jia-Zeng Su
Xin Peng
Guang-Yan Yu
Publikationsdatum: 18.07.2021
Verlag: Springer International Publishing
Erschienen in: Clinical Rheumatology / Ausgabe 12/2021
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-021-05859-5

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Materials and methods

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