TY - JOUR
T1 - Европейские рекомендации по IgG4-ассоциированным заболеваниям в гастроэнтерологии — рекомендации UEG и SGF, основанные на доказательствах
AU - the UEG guideline working group
AU - Löhr, J. Matthias
AU - Beuers, Ulrich
AU - Vujasinovic, Miroslav
AU - Alvaro, Domenico
AU - Frøkjær, Jens Brøndum
AU - Buttgereit, Frank
AU - Capurso, Gabriele
AU - Culver, Emma L.
AU - de-Madaria, Enrique
AU - Della-Torre, Emanuel
AU - Detlefsen, Sönke
AU - Dominguez-Munoz, Enrique
AU - Czubkowski, Piotr
AU - Ewald, Nils
AU - Frulloni, Luca
AU - Gubergrits, Natalya
AU - Duman, Deniz Guney
AU - Hackert, Thilo
AU - Iglesias-Garcia, Julio
AU - Kartalis, Nikolaos
AU - Laghi, Andrea
AU - Lammert, Frank
AU - Lindgren, Fredrik
AU - Okhlobystin, Alexey
AU - Oracz, Grzegorz
AU - Parniczky, Andrea
AU - Mucelli, Raffaella Maria Pozzi
AU - Rebours, Vinciane
AU - Rosendahl, Jonas
AU - Schleinitz, Nicolas
AU - Schneider, Alexander
AU - van Bommel, Eric F.H.
AU - Verbeke, Caroline Sophie
AU - Vullierme, Marie Pierre
AU - Witt, Heiko
N1 - Publisher Copyright:
© Russian Journal of Gastroenterology, Hepatology, Coloproctology.All right reserved.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Autoimmune pancreatitis type 1
KW - Biomarkers
KW - Cancer
KW - Diabetes mellitus
KW - Digestive
KW - Disease
KW - Glucocorticoids
KW - IgG4-related
KW - Immune-related cholangitis
KW - Other organ involvement
UR - http://www.scopus.com/inward/record.url?scp=85120771514&partnerID=8YFLogxK
U2 - 10.1177/2050640620934911
DO - 10.1177/2050640620934911
M3 - Article
AN - SCOPUS:85120771514
SN - 1382-4376
VL - 31
SP - 80
EP - 114
JO - Russian Journal of Gastroenterology, Hepatology, Coloproctology
JF - Russian Journal of Gastroenterology, Hepatology, Coloproctology
IS - 1
ER -