Clinical feature analysis of chronic nasal sinusitis in patients with immunoglobulin G4-related disease

Objective To analyze the clinical features of chronic rhino-sinusitis (CRS) in patients with immunoglobulin G4-related disease (IgG4-RD). Methods A retrospective analysis of the data from March 2013 to July 2015 in our Department of Rheumatology was conducted in patients who were diagnosed as IgG4-RD and were follow-up for over half a year. The clinical features and the results of laboratory tests were compared between of the case group and the control group. The t test, Mann-Whitney U test and Fisher' Exact Test (n<40) were used to analyze the data. Results Twenty-four cases in 44 cases of IgG4-RD were complicated with CRS (54%). The mean age was (49±13) years old, with the ratio of male: female was 2∶1; With the longer disease duration [4.0(1.0, 6.3) year vs 0.5(0.2, 4.3) year, U=-2.182, P=0.041], the more the number of organs involved [4.0(3.8, 5.3) vs 3.0(1.0, 4.0), U=-2.827, P=0.005], the higher the ratio of ocular involvement (89% vs 42%, P=0.013). The higher the percentage of eosinophils in peripheral blood [8.5%(4.0, 13.8) vs 3.3%(0.8, 8.5), P=0.043], the more common the allergic manifestations (61% vs 20%, P=0.026), the higher the operation times [1.5(1.0, 3.0) vs1.0(0, 10), U=2.096, P=0.048] before making the definitive diagnosis than the control group A. The level of ESR/CRP(56% vs 0, P=0.004) and the number of IgG4 positive plasma cells [57.5(50.0, 66.3)/HP vs 10.0(1.8, 20.0)/HP, U=4.358, P<0.01] and the percentage of IgG4/IgG positive plasma cell (40% vs 10%, P<0.01) in the nasal mucosal tissues of the IgG4-related chronic rhino-sinusitis were higher than patients with ordinary CRS (the control group B), but there was no difference in the severity of sinusitis manifestations between patients with IgG4-related chronic rhino-sinusitis and the regular CRS. Conclusion IgG4-related chronic rhino-sinusitis is different from regular CRS, and is closely associated with IgG4-related ocular lesion. IgG4-related chronic rhino-sinusitis has some clinical features which are different from other phenotypes of IgG4-related diseases. Key words: Immunoglobulin G; Sinusitis; Immunoglobulin G4-related disease