Experience from the first UK inter-regional specialist multidisciplinary meeting in the diagnosis and management of IgG4-related disease.
IgG4-related disease
inflammation
multidisciplinary team
rituximab
Journal
Clinical medicine (London, England)
ISSN: 1473-4893
Titre abrégé: Clin Med (Lond)
Pays: England
ID NLM: 101092853
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
entrez:
17
5
2020
pubmed:
18
5
2020
medline:
15
5
2021
Statut:
ppublish
Résumé
Immunoglobulin G4-related disease (IgG4-RD) is a complex multisystem fibro-inflammatory disorder, requiring diagnostic differentiation from malignancy and other immune-mediated conditions, and careful management to minimise glucocorticoid-induced toxicity and prevent progressive organ dysfunction. We describe the experience of the first inter-regional specialist IgG4-RD multidisciplinary team meeting (MDM) incorporating a broad range of generalists and specialists, held 6-weekly via web-link between Oxford University Hospitals NHS Foundation Trust and University College London Hospitals NHS Foundation Trust. Over 3 years, there were 206 discussions on 156 patients. Of these, 97 (62%) were considered to have definite or possible IgG4-RD; 67% had multi-organ involvement and 23% had a normal serum IgG4. The average number of specialist opinions sought prior to MDM was four per patient. Management was changed in the majority of patients (74%) with the treatment escalation recommended in 61 cases, including 19 for rituximab. Challenges arose from delays and misdiagnosis, cross-specialty presentation and the management of sub-clinical disease. Our cross-discipline IgG4-RD MDM enabled important diagnostic and management decisions in this complex multisystem disorder, and can be used as a model for other centres in the UK.
Identifiants
pubmed: 32414739
pii: 20/3/e32
doi: 10.7861/clinmed.2019-0457
pmc: PMC7354052
doi:
Substances chimiques
Immunoglobulin G
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e32-e39Informations de copyright
© Royal College of Physicians 2020. All rights reserved.
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