Cory Perugino, DO, discusses which symptom patterns are and are not associated with IgG4-RD.
Transcript
There are some important, kind of negative, attributes of symptoms that would have me thinking away from IgG4-related disease. So it’s a little bit of an inverse answer.
The tempo of the disease is really a slow-moving, smoldering, very slow-tempo disease. It really doesn’t cause this kind of brisk or abrupt or acute inflammation, acute or abrupt swelling. So the chronicity is a really important aspect. It really should be slow moving. When there are elements of acuity, it makes me think less likely about IgG4-related disease. So, chronicity and insidious nature is an important one.
It generally doesn’t cause a lot of pain. So when the organs are enlarged, like the salivary or the lacrimal glands around the eyes, they’re really not tender on exam and they don’t really cause a lot of discomfort for patients. So, really the kind of painless enlargement or painless swelling is an important feature, particularly when it’s around the eyes or, you know, under the chin or around the cheeks.
And similarly, that could take the form on imaging of concern for cancer, you know, concern for masses that have been identified on CAT scan or MRI imaging in the past. So sometimes there’s a history of this. If patients have had imaging and, you know, some doctors thought that there was concern for cancer, but nothing ever came out from that, that’s an important aspect of history as well.
And then lastly, any issues related to the pancreas or the bile ducts, you know, or the liver, those are important features as well.
