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Manifestations of IgG4-related disease in the head and neck

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Kamiński B., Millak-Wojtan D., Guzera Z.
Polski Przegląd Otorynolaryngologiczny
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2021
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vol. 10(2)
25-29
EN
IgG4-related disease (IgG4-RD) is an immune-mediated disease condition that can affect almost any organ, including the head and neck. It is a chronic, systemic inflammation of unknown etiology. Tumor formation is the most common clinical symptom. Any tumor in the head and neck area is always a concern for an otorhinolaryngologist, head and neck surgeon, that we are dealing with malignant neoplastic growth. Ultrasound imaging, computer tomography, magnetic resonance imaging and even fine needle aspiration biopsy usually do not exclude neoplastic hyperplasia. Only open biopsy or excision biopsy followed by histopathological examination suggest the diagnosis of IgG4-RD, which requires further diagnosis, mainly serological. The authors present the most common IgG4-RD in the head and neck area, diagnostic criteria and their differentiation from apparently similar diseases.
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Sjögren's syndrom – the review of the latest diagnostic guidelines essential for otolaryngologists

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Kruk K., Rzepakowska A., Osuch-Wójcikiewicz E., Niemczyk K.
Polski Przegląd Otorynolaryngologiczny
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2019
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vol. 8(2)
1-6
EN
Sjogren’s syndrome (SS) is a complex connective tissue disease with autoimmune background and high clinical, radiological and molecular heterogeneity. SS is typically manifested by sicca syndrome, characterized by dry eyes and dry mouth due to autoimmune-induced inflammation of the lacrimal and salivary glands. Complications of sicca syndrome are dental caries, oral candidiasis, dysosmia, dysgeusia, difficulties in swallowing and chewing. SS may coexist with other diseases of rheumatoid and autoimmune etiology. SS is linked to an 16-fold increased risk of non-Hodgkin lymphoma. Early diagnosis results in appropriate treatment and may slow down the course of the disease and limit extraglandular involvement. Due to diverse clinical phenotypes and symptomatology, establishing of the diagnosis is often difficult. In 2016 the AmericanEuropean Consensus Group (AECG) and European League Against Rheumatism (EULAR) proposed a classification system that defines SS as a systemic disease. Diagnostic tools in establishing SS diagnosis are serological tests, ultrasonography, Schirmer’s test, unstimulated whole saliva flow rate and Ocular Staining Score. The complete curing of SS is still not possible. As a complex multisystem disease, SS requires multidisciplinary cooperation and individual diagnostic and therapeutic approaches in patients. Therapy is focused on the treatment of symptoms and prophylaxis of complications. The laryngological treatment of oral cavity symptoms in SS include supervision of proper oral hygiene habits and adequate fluids supplementation. The EULAR Sjögren’s syndrome disease activity index (ESSDAI) and Clinical Oral Dryness Score(CODS) are used to monitor disease progression and treatment effectiveness.
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