ObjectiveTo evaluate the clinical value of detecting specific IgG against Toxocara canis in intraocular fluid for the diagnosis of ocular toxocariasis(OT). MethodsFifty patients diagnosed as having OT(OT group), 152 otolaryngology patients (serum control group) and 70 other oculopathy patients (intraocular fluid control group) were enrolled in the study. Intraocular fluids(28 aqueous humor and 22 vitreous humor) and serum samples of OT group were analyzed for specific IgG against Toxocara canis by enzymelinked immunosorbent assay, so were the intraocular fluids(46 aqueous humor and 24 vitreous humor) and 152 serum samples of two control group. Specific IgG level was compared between paired serum and intraocular fluids of OT group. Results68.00% serum samples of OT group were positive for specific IgG against Toxocara canis and the U value was 20.42±17.01. The positive rate was 88.00% and U value 25.72±23.04 in intraocular fluids. In serum control group, it was 2.63% and 2.37±2.71 respectively. The intraocular fluids were negative and U value 0.69±0.34 in intraocular fluid control group. The difference of specific IgG level was proved significant between OT group and control group in both serum and intraocular fluid (Z=8.962, 8.120; P=0.000, 0.000). Twenty-eight patients (56.00%) were positive for specific IgG in both serum and intraocular fluid. Six patients (12.00%) were positive only in serum, and 16 patients (32.00%) only in intraocular fluid. The positive rate was significantly higher in intraocular fluid than in serum (χ2=4.720, P=0.028). Moreover, 64.00% intraocular fluid showed higher specific IgG level than pared serum. ConclusionThe complementary detection of intraocular specific IgG have referential value in diagnosing ocular toxocariasis.
ObjectTo systematically review the efficacy and safety of intravenous immunoglobulin (IVIG) for children with severe hand, foot and mouth disease in China. MethodDatabases including CNKI, CBM, WanFang Data, PubMed and The Cochrane Library (Issue 2, 2015) were searched to collect randomized controlled trials (RCTs) about IVIG combined with conventional therapy versus conventional therapy alone for severe hand, foot and mouth disease from inception to March 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 and Stata 9.0 software. ResultA total of 23 RCTs involving 2271 patients were included. The results of meta-analysis showed that, compared with the conventional therapy group, the IVIG group had higher total effective rate (RR=1.18, 95%CI 1.11 to 1.26, P<0.00001), shorter fever relieving time (MD=-1.47, 95%CI -1.80 to -1.15, P<0.00001), shorter rash regression time (MD=-1.61, 95%CI -2.51 to -0.71, P=0.0005), shorter remission time of nervous symptoms (MD=-2.14, 95%CI -3.02 to -1.25, P<0.00001), shorter mouth ulcer regression time (MD=-1.36, 95%CI -2.27 to -0.4, P=0.004), and shorter average length of hospital stay (MD=-2.46, 95%CI-3.29 to -1.63, P<0.00001). ConclusionCompared with conventional therapy alone, IVIG combined with conventional therapy can improve the effect for severe hand, foot and mouth disease. Due to the limited quality of the include studies, more high quality studies are needed to verify the above conclusion.
IgG4-related disease (IgG4-RD) is a chronic, immune-mediated inflammatory and fibrotic condition that can affect virtually any organ system. While some patients experience involvement of only a single organ, isolated IgG4-RD of the mediastinum is even rarer. This article reports a case of a 48-year-old male patient with isolated IgG4-RD of the middle mediastinum. After a biopsy failed to establish a definitive diagnosis, the patient underwent a right thoracotomy-assisted mediastinal tumor resection via video-assisted thoracoscopic surgery. The tumor was completely resected during the procedure, which lasted 130 minutes, with an estimated blood loss of approximately 50 mL. The patient had a favorable postoperative course and satisfactory clinical outcome. No glucocorticoid or other medical treatment was administered postoperatively, and there was no recurrence during a 6-month follow-up period.
ObjectiveTo learn the serum immunoglobulin G4 (IgG4) level in patients with pemphigus vulgaris (PV) in the active phase by detecting the IgG4 concentration in the patients with PV. MethodsWe collected the serum samples from patients with active-phase PV (including acute-onset and chronic active phases) between April and December 2014. The serum IgG4 level was detected by immuno-scatter turbidmetry, and the difference of serum IgG4 level between PV patients and normal subjects was assessed by Student's t-test. ResultsThirty-two patients with pemphigus vulgaris in the active phase were enrolled for this study, among whom 22 (including 8 males and 14 females) had normal serum IgG4 level, 8 (including 3 males and 5 females) higher and 2 (including 1 male and 1 female) lower. Compared with normal subjects, the average level of serum IgG4 in PV patients was not significantly different (P>0.05). The serum IgG4 level of acute-onset and chronic active PV patients was (1.015±0.825) g/L and (1.058±1.133) g/L, respectively, with no significant difference (P>0.05). ConclusionThe serum IgG4 level of patients with pemphigus vulgaris in the active phase can be normal, higher or lower. And there is no obvious difference in the serum IgG4 level between acute-onset and chronic active PV patients.
Objective To investigate the clinical features, pathological and immunological manifestations, as well as treatment outcomes in patients with immunoglobulin (Ig) A pemphigus. Methods The clinical, pathological, immunological, and follow-up data of IgA pemphigus patients diagnosed in the Department of Dermatology and Venereology, West China Hospital of Sichuan University between January 1, 2014 and December 31, 2024 were retrospectively analyzed. Results Ultimately, 8 patients were included, including 6 females and 2 males, with an average age of onset of 42.4 years and an average age of medical consultation of 45.3 years. All 8 patients presented with erythema and papules, including 6 cases with yellow white pustules and 2 cases with blisters. The affected areas of the skin lesions included the trunk, limbs, head and neck, and palms and soles, with 4 cases diagnosed with subcorneal pustular dermatosis type IgA pemphigus, 1 case diagnosed with intraepidermal neutrophilic dermatosis type, and the remaining 3 cases had atypical histopathological changes. The 7 successfully followed up patients achieved disease activity control, and during the follow-up period, 5 patients experienced at least 1 recurrence. A total of 6 patients completed itching assessment before and after treatment (3 severe itching and 1 moderate itching), and after treatment, the itching in all patients decreased to mild. Conclusions IgA pemphigus patients often present with blisters and pustules on the trunk and limbs, with a higher incidence of itching. Although most patients have a good response to treatment, recurrence is not uncommon during follow-up.
Objective To observe the turbulence of regional intra-artery implantation chemotherapy and peripheral venous chemotherapy on immunologic function of patients. Methods Two weeks after radical operation of gastric carcinoma, chemotherapy was performed. Eighty-three patients were divided into two groups, one (42 patients) received peripheral venous chemotherapy (PVC) and the other (41 patients) received regional intra-artery implantation pump chemotherapy (RAIPC). The serum T-lymphocyte subsets and immunoglobulin level before and 1-4 days after the chemotherapy were measured. Results After PVC, proportion of CD3 and CD4, CD4/CD8 and IgG, IgA, IgM concentration in PVC group were significantly decreased compared with those before PVC （P＜0.05， P＜0.01）, and it is the same when compared with postRAIPC patients except for CD4 and IgM （P＜0.05）. In RAIPC group, there were no significant changes in proportion of CD3, CD4 and CD8, CD4/CD8 and IgG, IgA concentration between pre- and post-RAIPC patients. Conclusion After radical operation of gastric carcinoma, RAIPC affects the immunologic function more moderate than PVC.
Immunoglobulin A nephropathy is a common primary glomerular disease, and its targeted therapy focuses on key links such as upstream regulation of galactose-deficient immunoglobulin A1 production, blocking immune complex deposition, inhibiting complement activation, and downstream inflammatory responses. This article systematically reviews the latest research progress of targeted therapeutic drugs based on the pathogenesis of immunoglobulin A nephropathy, summarizes their mechanisms of action and clinical research evidence, and explores the current challenges and future development directions, in order to provide references for clinical practice and research.
ObjectiveTo explore the effects of intraoperative lymphatic chemotherapy (LC) on immune functions of patients after esophageal carcinoma resection. MethodsPatients who underwent intraoperative LC during esophageal carcinoma resection in the Department of Thoracic Surgery of West China Hospital from March to October,2013 were prospectively included in this study, and patients who underwent esophageal carcinoma resection without intraoperative LC during the same period were also included as the control group. All the patients were divided into a pacitaxel LC group,a fluorouracil LC group,and a control group without LC. A total of 37 patients were included in this study including 25 male and 12 female patients with their age of 42-76 (61.89±7.95) years. There were 15 patients in the pacitaxel LC group,15 patients in the fluorouracil LC group,and 7 patients in the control group. Representative indexes of humoral immunity and cellular immunity in peripheral blood of all the patients were examined preoperatively and on the third and seventh postoperative day, and then compared among the 3 groups. ResultsAll the immune indexes of the 3 groups decreased after surgery to different extent. There was no statistical difference in preoperative and postoperative difference of immunoglobulin concentration between LC groups and the control group (P>0.05). CD8+ T cell count recovered more rapidly after surgery in LC groups than the control group. CD3+ T cells recovered most rapidly after surgery in the fluorouracil LC group. ConclusionLC is beneficial for the recovery of cytotoxic effects of T lymphocytes but may not promote humoral immunity for patients after esophageal carcinoma resection.
ObjectiveTo systematically review the efficacy of immunoglobulin for treatment of clinical diagnosed viral encephalitis in China.MethodsCNKI, VIP, WanFang Data, PubMed, ScienceDirect, The Cochrane Library and EMbase databases were electronically searched to collect randomized controlled trials (RCTs) of immunoglobulin for treatment of clinical diagnosed viral encephalitis in China from inception to January 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.4 software.ResultsA total of 57 RCTs involving 4 431 patients were included. The results of meta-analysis showed that in both children and adults of clinically diagnosed viral encephalitis, the combination of immunoglobulin could reduce the mean recovery time of fever, unconsciousness, convulsion, emesis, average hospitalization time, and non-effective rate. Moreover, there was no difference in the incidence of adverse effects between the two groups.ConclusionsCurrent evidence shows that immunoglobulin is superior to conventional therapies both in adults and children patients of clinically diagnosed viral encephalitis. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Immunoglobulin G4-related disease (IgG4-RD) is a new disease entity recognized at the start of this century noted to be involving many organ systems including endocrine system and thyroid in particular. It represents an immune mediated fibro inflammatory condition with characteristic histopathological appearance affecting single or multiple organs. In general, immunoglobulin G4-related thyroid disease (IgG4-RTD) is rarely considered and it may be isolated or with other organ involvement. Four subcategories of IgG4-RTD have been identified so far: Riedel thyroiditis, fibrosing variant of Hashimoto thyroiditis, immunoglobulin G4-related Hashimoto thyroiditis, and Graves disease with elevated immunoglobulin G4 levels. The diagnostic approach is complex and the work up relies on the coexistence of clinical features, histological features and serological evidence. Demonstration of the classic histopathological features is vital to diagnose IgG4-RD in most cases, and biopsy proof is preferred strongly by most disease experts before the initiation of treatment. The treatments for IgG4-RTD include medical and surgical options. Steroids are first line treatment though it may need further evaluation. Tamoxifen and rituximab are second line treatment for steroid resistant patients. Surgical excision of thyroid gland in presence of compression symptoms is the surgical option. Inspite of pathophysiology of the disease being poorly understood till now, early and prompt diagnosis and an early treatment initiation can improve the outcomes.