caa a22 4500 445883421 CHVBK 20180317145551.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s10157-011-0521-2 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0521-2 Proposal for diagnostic criteria for IgG4-related kidney disease [Elektronische Daten] [Mitsuhiro Kawano, Takako Saeki, Hitoshi Nakashima, Shinichi Nishi, Yutaka Yamaguchi, Satoshi Hisano, Nobuaki Yamanaka, Dai Inoue, Motohisa Yamamoto, Hiroki Takahashi, Hideki Nomura, Takashi Taguchi, Hisanori Umehara, Hirofumi Makino, Takao Saito] Background: IgG4-related disease has attracted wide attention recently. It is characterized by a high level of serum IgG4 and dense infiltration of IgG4-positive plasma cells into multiple organs, with the kidney being one representative target. Although several sets of diagnostic criteria for autoimmune pancreatitis (AIP) are available and renal lesion is recognized as an extra-pancreatic manifestation of AIP, it is difficult to differentiate IgG4-related tubulointerstitial nephritis (TIN) without AIP from other types of TIN. To clarify the entity of IgG4-related kidney disease (IgG4-RKD) and support in-depth studies, the Japanese Society of Nephrology has established a working group to prepare diagnostic criteria for IgG4-RKD. Method: The working group analyzed 41 patients with IgG4-RKD, and collected the following data to devise a diagnostic algorithm and diagnostic criteria for IgG4-RKD: clinical features including extra-renal organ involvement, urinalysis and serological features including serum IgG4 levels, imaging findings demonstrated by computed tomography (CT), renal histology with IgG4 immunostaining, and response to steroid therapy. Results: The conditions for criteria are as follows. (1) Presence of some kidney damage, as manifested by abnormal urinalysis or urine marker(s) and/or decreased kidney function with either elevated serum IgG level, hypocomplementemia, or elevated serum IgE level. (2) Kidney imaging studies showing abnormal renal imaging findings, i.e., multiple low density lesions on enhanced CT, diffuse kidney enlargement, hypovascular solitary mass in the kidney, and hypertrophic lesion of the renal pelvic wall without irregularity of the renal pelvic surface. (3) Serum IgG4 level exceeding 135mg/dl. (4) Renal histology showing two abnormal findings: (a) dense lymphoplasmacytic infiltration with infiltrating IgG4-positive plasma cells >10/high power field (HPF) and/or ratio of IgG4-positive plasma cells/IgG positive plasma cells >40%. (b) Characteristic ‘storiform' fibrosis surrounding nests of lymphocytes and/or plasma cells. (5) Extra-renal histology showing dense lymphoplasmacytic infiltration with infiltrating IgG4-positive plasma cells >10/HPF and/or ratio of IgG4-positive plasma cells/IgG-positive plasma cells >40%. The diagnosis is classified into 3 stages of definite, probable and possible according to the combinations of the above conditions. Thirty-nine cases (95.1%) were diagnosed with IgG4-RKD according to the criteria. Conclusion: The provisional criteria and algorithm appear to be useful for clarifying the entity of IgG4-RKD and seeking underlying IgG4-RKD cases; however, further experience is needed to confirm the validity of these criteria. Japanese Society of Nephrology, 2011 IgG4-related kidney disease nationallicence Diagnostic criteria nationallicence IgG4 nationallicence Tubulointerstitial nephritis nationallicence Kawano Mitsuhiro Division of Rheumatology, Department of Internal Medicine, Kanazawa University Hospital, Kanazawa, Japan aut Saeki Takako Department of Internal Medicine, Nagaoka Red Cross Hospital, Nagaoka, Japan aut Nakashima Hitoshi Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, 814-0180, Fukuoka, Japan aut Nishi Shinichi Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan aut Yamaguchi Yutaka Yamaguchi's Pathology Laboratory, Chiba, Japan aut Hisano Satoshi Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan aut Yamanaka Nobuaki Tokyo Kidney Research Institute, Tokyo, Japan aut Inoue Dai Department of Radiology, Toyama Prefectural Central Hospital, Toyama, Japan aut Yamamoto Motohisa First Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan aut Takahashi Hiroki First Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan aut Nomura Hideki Department of General Medicine, Kanazawa University Hospital, Kanazawa, Japan aut Taguchi Takashi Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan aut Umehara Hisanori Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan aut Makino Hirofumi Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Okayama, Japan aut Saito Takao Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, 814-0180, Fukuoka, Japan aut Clinical and Experimental Nephrology Springer Japan 15/5(2011-10-01), 615-626 1342-1751 15:5<615 2011 15 10157 https://doi.org/10.1007/s10157-011-0521-2 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0521-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kawano Mitsuhiro Division of Rheumatology, Department of Internal Medicine, Kanazawa University Hospital, Kanazawa, Japan aut NATIONALLICENCE 700 1- Saeki Takako Department of Internal Medicine, Nagaoka Red Cross Hospital, Nagaoka, Japan aut NATIONALLICENCE 700 1- Nakashima Hitoshi Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, 814-0180, Fukuoka, Japan aut NATIONALLICENCE 700 1- Nishi Shinichi Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan aut NATIONALLICENCE 700 1- Yamaguchi Yutaka Yamaguchi's Pathology Laboratory, Chiba, Japan aut NATIONALLICENCE 700 1- Hisano Satoshi Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Yamanaka Nobuaki Tokyo Kidney Research Institute, Tokyo, Japan aut NATIONALLICENCE 700 1- Inoue Dai Department of Radiology, Toyama Prefectural Central Hospital, Toyama, Japan aut NATIONALLICENCE 700 1- Yamamoto Motohisa First Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan aut NATIONALLICENCE 700 1- Takahashi Hiroki First Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan aut NATIONALLICENCE 700 1- Nomura Hideki Department of General Medicine, Kanazawa University Hospital, Kanazawa, Japan aut NATIONALLICENCE 700 1- Taguchi Takashi Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan aut NATIONALLICENCE 700 1- Umehara Hisanori Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan aut NATIONALLICENCE 700 1- Makino Hirofumi Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Okayama, Japan aut NATIONALLICENCE 700 1- Saito Takao Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, 814-0180, Fukuoka, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/5(2011-10-01), 615-626 1342-1751 15:5<615 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer