European Guideline on IgG4-related digestive disease - UEG and SGF evidence-based recommendations
Por:
Lohr, J, Beuers, U, Vujasinovic, M, Alvaro, D, Frokjaer, J, Buttgereit, F, Capurso, G, Culver, E, De-Madaria, E, Della-Torre, E, Detlefsen, S, Dominguez-Munoz, E, Czubkowski, P, Ewald, N, Frulloni, L, Gubergrits, N, Duman, D, Hackert, T, Iglesias-Garcia, J, Kartalis, N, Laghi, A, Lammert, F, Lindgren, F, Okhlobystin, A, Oracz, G, Parniczky, A, Mucelli, R, Rebours, V, Rosendahl, J, Schleinitz, N, Schneider, A, van Bommel, E, Verbeke, C, Vullierme, M, Witt, H, Besselink, M, Bruno, M, Czako, L, del Chiaro, M, Filippova, O, Fukuda, A, Gaujoux, S, Hart, P, Hegyi, P, Jonas, E, Kahraman, A, Kleger, A, Kuryata, O, Laukkarinen, J, Lerch, M, Marchegiani, G, Marschal, H, Matos, C, Molad, Y, Oguz, D, Pukitis, A, Satoi, S, Stone, J, Verheij, J, de Vries, N and UEG Guideline Working Grp
Publicada:
1 jul 2020
Ahead of Print:
1 jun 2020
Resumen:
The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6-0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2-4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added.
Filiaciones:
Lohr, J:
Karolinska Univ Hosp, Dept Upper Gastrointestinal Dis, Stockholm, Sweden
Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden
Beuers, U:
Amsterdam Univ Med Ctr, Dept Gastroenterol & Hepatol, Locat AMC, Amsterdam, Netherlands
Vujasinovic, M:
Karolinska Univ Hosp, Dept Upper Gastrointestinal Dis, Stockholm, Sweden
Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Alvaro, D:
Sapienza Univ Rome, Dept Translat & Precis Med, Rome, Italy
Frokjaer, J:
Aalborg Univ Hosp, Dept Radiol, Aalborg, Denmark
Buttgereit, F:
Charite Univ Med Berlin, Dept Rheumatol & Clin Immunol, Berlin, Germany
Capurso, G:
IRCCS San Raffaele Sci Inst, Pancreas Translat & Clin Res Ctr, PancreatoBiliary Endoscopy & EUS Div, Milan, Italy
Culver, E:
Univ Oxford, John Radcliffe Hosp, Translat Gastroenterol Unit, Oxford, England
Univ Oxford, Nuffield Dept Med, Oxford, England
:
Alicante Univ Gen Hosp, Gastroenterol Dept, ISABIAL, Alicante, Spain
Della-Torre, E:
Univ Vita Salute San Raffaele, Sch Med, Milan, Italy
IRCCS San Raffaele Sci Inst, Unit Immunol Rheumatol Allergy & Rare Dis UnIRAR, Milan, Italy
Detlefsen, S:
Odense Univ Hosp, Odense Pancreas Ctr OPAC, Dept Pathol, Odense, Denmark
Dominguez-Munoz, E:
Univ Hosp Santiago de Compostela, Dept Gastroenterol & Hepatol, Santiago De Compostela, Spain
Czubkowski, P:
Childrens Mem Hlth Inst, Dept Gastroenterol Hepatol Nutr Disorders & Pedia, Warsaw, Poland
Ewald, N:
Johannes Wesling Univ Hosp, Inst Endocrinol Diabetol & Metab, Minden, Germany
Justus Liebig Univ Giessen, Giessen, Germany
Frulloni, L:
Univ Verona, Pancreas Inst, Dept Med, Verona, Italy
Gubergrits, N:
Donetsk Natl Med Univ, Dept Internal Med, Lyman, Ukraine
Duman, D:
Marmara Univ, Sch Med, Dept Gastroenterol, Istanbul, Turkey
Hackert, T:
Heidelberg Univ, Dept Gen Visceral & Transplantat Surg, Heidelberg, Germany
Iglesias-Garcia, J:
Univ Hosp Santiago de Compostela, Dept Gastroenterol & Hepatol, Santiago De Compostela, Spain
Kartalis, N:
Karolinska Univ Hosp, Dept Abdominal Radiol, Stockholm, Sweden
Laghi, A:
Sapienza Univ Rome, St Andrea Hosp, Dept Surg & Med Sci & Translat Med, Rome, Italy
Lammert, F:
Saarland Univ Med Ctr, Dept Med 2, Homburg, Germany
Lindgren, F:
Karolinska Univ Hosp, Dept Pediat Gastroenterol Hepatol & Nutr, Stockholm, Sweden
Okhlobystin, A:
IM Sechenov First Moscow State Med Univ, Moscow, Russia
Oracz, G:
Childrens Mem Hlth Inst, Dept Gastroenterol Hepatol Nutr Disorders & Pedia, Warsaw, Poland
Parniczky, A:
Univ Pecs, Szentagothai Res Ctr, Inst Translat Med, Budapest, Hungary
Heim Pal Natl Insitute Pediat, Budapest, Hungary
Mucelli, R:
Karolinska Univ Hosp, Dept Abdominal Radiol, Stockholm, Sweden
Rebours, V:
Univ Paris, Beaujon Hosp, Pancreatol Dept, Clichy, France
Rosendahl, J:
Martin Luther Univ Halle Wittenberg, Dept Internal Med 1, Halle, Germany
Schleinitz, N:
Aix Marseille Univ, AP HM, Dept Med Interne Timone, Marseille, France
Schneider, A:
Klinikum Bad Hersfeld, Dept Gastroenterol & Hepatol, Bad Hersfeld, Germany
van Bommel, E:
Albert Schweitzer Hosp, Dutch Natl Ctr Expertise Retroperitoneal Fibrosis, Dept Internal Med, Dordrecht, Netherlands
Verbeke, C:
Oslo Univ Hosp, Dept Pathol, Oslo, Norway
Univ Oslo, Oslo, Norway
Vullierme, M:
Beaujon Hosp, Radiol Dept, Clichy, France
Witt, H:
Tech Univ Munich, Paediat Nutr Med, Else Kroner Fresenius Zentrum Ernahrungsmed, Freising Weihenstephan, Germany
Besselink, M:
Univ Amsterdam, Canc Ctr Amsterdam, Dept Surg, Amsterdam UMC, Amsterdam, Netherlands
Bruno, M:
Univ Med Ctr, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands
Univ Med Ctr, Erasmus Med Ctr, Rotterdam, Netherlands
Czako, L:
Univ Szeged, Dept Med 1, Szeged, Hungary
del Chiaro, M:
Univ Colorado, Dept Surg, Div Surg Oncol, Anschutz Med Campus, Denver, CO 80202 USA
CLINTEC Karolinska Inst, Div Surg, Stockholm, Sweden
Johns Hopkins Univ, Dept Surg, Div Surg Oncol, Baltimore, MD USA
Filippova, O:
Dnipropetrovsk State Med Acad, Internal Med & Physiol 2, Dnipro, Ukraine
Fukuda, A:
Kyoto Univ, Dept Gastroenterol & Hepatol, Grad Sch Med, Kyoto, Japan
Gaujoux, S:
Cochin Hosp, AP HP, Dept Pancreat & Endocrine Surg, Paris, France
Hart, P:
Ohio State Univ, Wexner Med Ctr, Div Gastroenterol Hepatol & Nutr, Columbus, OH 43210 USA
Hegyi, P:
Univ Pecs, Szentagothai Res Ctr, Med Sch, Inst Translat Med, Pecs, Hungary
Jonas, E:
Univ Cape Town, Dept Surg, Surg Gastroenterol Unit, Cape Town, South Africa
Groote Schuur Hosp, Cape Town, South Africa
Kahraman, A:
Univ Clin Essen, Dept Gastroenterol & Hepatol, Essen, Germany
Kleger, A:
Univ Ulm, Dept Internal Med 1, Univ Med Ctr Ulm, Ctr Internal Med, Ulm, Germany
Kuryata, O:
Dnipropetrovsk State Med Acad, Internal Med & Physiol 2, Dnipro, Ukraine
Laukkarinen, J:
Tampere Univ, Tampere Univ Hosp, Dept Gastroenterol & Alimentary Tract Surg, Tampere, Finland
Tampere Univ, Fac Med & Hlth Technol, Tampere, Finland
Lerch, M:
Univ Med Greifswald, Dept Med A, Greifswald, Germany
Marchegiani, G:
Univ Verona, Dept Surg, Pancreas Inst, Verona, Italy
Hosp Trust Verona, Verona, Italy
Marschal, H:
Univ Gothenburg, Wallenberg Lab, Dept Mol & Clin Med, Gothenburg, Sweden
Matos, C:
Champalimaud Ctr Unknown, Radiol Dept, Lisbon, Portugal
Molad, Y:
Tel Aviv Univ, Beilinson Hosp, Rabin Med Ctr, Inst Rheumatol, Petah Tiqwa, Israel
Tel Aviv Univ, Sackler Fac Med, Felsenstein Med Res Ctr, Lab Inflammat Res, Petah Tiqwa, Israel
Oguz, D:
Kirikkale Univ, Dept Gastroenterol, Sch Med, Kirikkale, Turkey
Pukitis, A:
Pauls Stradins Clin Univ Hosp, Ctr Gastroenterol Hepatol & Nutr, Riga, Latvia
Univ Latvia, Riga, Latvia
Satoi, S:
Kansai Med Univ, Dept Surg, Div Pancreatobiliary Surg, Hirakata, Osaka, Japan
Stone, J:
Harvard Med Sch, Massachusetts Gen Hosp, Edward A Fox Chair Med, Boston, MA 02115 USA
Verheij, J:
Univ Amsterdam, Canc Ctr Amsterdam, Dept Pathol, Amsterdam UMC, Amsterdam, Netherlands
de Vries, N:
Univ Amsterdam, Acad Med Ctr, Dept Clin Immunol & Rheumatol, Amsterdam, Netherlands
Green Published, Bronze
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