Top Tweets for #dacryoadenitis

7 months ago

The 2023 revised diagnostic criteria for #IgG4-related #dacryoadenitis and #sialadenitis (IgG4-DS, also known as #Mikulicz disease), published by the Japanese Study Group for IgG4-related Dacryoadenitis and Sialadenitis resolve several limitations of the 2008 version by increasing flexibility and accessibility. The study group identified and addressed three key limitations: 1. Broader Inclusion of Clinical Presentation The criteria now include asymmetric involvement or cases with fewer than two pairs of affected glands (one or more glands). This expands the diagnosis to milder or unilateral/asymmetric forms that were previously excluded. 2. Updated Histopathological Thresholds The required IgG4-positive plasma cell infiltration was standardized to: ◦IgG4+/IgG+ ratio > 0.4 (i.e., >40%) ◦IgG4+ cells >10 per high-power field (HPF) This aligns the organ-specific criteria more closely with general IgG4-related disease standards while remaining practical. 3. Allowance for Less Invasive Biopsy Labial salivary gland biopsy is now permitted for histopathological confirmation. This is a simpler, outpatient procedure compared to lacrimal or major salivary gland biopsies, making diagnosis more accessible. The 2023 revised criteria are expected to facilitate earlier and more accurate diagnosis, particularly in atypical presentations or settings where major gland biopsy is difficult or unavailable. The changes were developed through literature review, data collection, expert consensus, and public comments. These updates better reflect the real-world spectrum of IgG4-DS while maintaining specificity to differentiate it from mimics (e.g., Sjögren’s syndrome, lymphoma, or other causes of glandular swelling). *Adapted from: Kanda M, Nagahata K, Moriyama M, et al. The 2023 revised diagnostic criteria for IgG4-related dacryoadenitis and sialadenitis. Mod Rheumatol. 2025;35(3):542-547. 🔗https://t.co/UWY12FhygU *Clinical photographs from: Takano K, Yamamoto M, Takahashi H, Himi T. Recent advances in knowledge regarding the head and neck manifestations of IgG4-related disease. Auris Nasus Larynx. 2017;44(1):7-17. 🔗 https://t.co/PXX3f71Pui

alb_giraldo's tweet photo. The 2023 revised diagnostic criteria for #IgG4-related #dacryoadenitis and #sialadenitis (IgG4-DS, also known as #Mikulicz disease), published by the Japanese Study Group for IgG4-related Dacryoadenitis and Sialadenitis resolve several limitations of the 2008 version by increasing flexibility and accessibility.

The study group identified and addressed three key limitations:

1. Broader Inclusion of Clinical Presentation
The criteria now include asymmetric involvement or cases with fewer than two pairs of affected glands (one or more glands). This expands the diagnosis to milder or unilateral/asymmetric forms that were previously excluded.

2. Updated Histopathological Thresholds The required IgG4-positive plasma cell infiltration was standardized to:
◦IgG4+/IgG+ ratio > 0.4 (i.e., >40%)
◦IgG4+ cells >10 per high-power field (HPF) This aligns the organ-specific criteria more closely with general IgG4-related disease standards while remaining practical.

3. Allowance for Less Invasive Biopsy Labial salivary gland biopsy is now permitted for histopathological confirmation. This is a simpler, outpatient procedure compared to lacrimal or major salivary gland biopsies, making diagnosis more accessible.

The 2023 revised criteria are expected to facilitate earlier and more accurate diagnosis, particularly in atypical presentations or settings where major gland biopsy is difficult or unavailable. The changes were developed through literature review, data collection, expert consensus, and public comments.

These updates better reflect the real-world spectrum of IgG4-DS while maintaining specificity to differentiate it from mimics (e.g., Sjögren’s syndrome, lymphoma, or other causes of glandular swelling).

*Adapted from: Kanda M, Nagahata K, Moriyama M, et al. The 2023 revised diagnostic criteria for IgG4-related dacryoadenitis and sialadenitis. Mod Rheumatol. 2025;35(3):542-547.
🔗https://t.co/UWY12FhygU

*Clinical photographs from: Takano K, Yamamoto M, Takahashi H, Himi T. Recent advances in knowledge regarding the head and neck manifestations of IgG4-related disease. Auris Nasus Larynx. 2017;44(1):7-17.
🔗 https://t.co/PXX3f71Pui

Indiana University Infectious Diseases Fellowship @IUIDfellowship

over 5 years ago

#dacryoadenitis treatment abx (empiric amp-sulbactam) and incision and drainage of lacrimal sac abscess. Chronic/recurrent may require dacryocystorhinostomy

Indiana University Infectious Diseases Fellowship @IUIDfellowship

over 5 years ago

#dacryoadenitis chronic is rare. some case reports describe with MTB. Most chronic are inflammatory rather than infectious (Sjogren, sarcodisosis, some cases of Crohns and Wegeners may present as chronic)

Indiana University Infectious Diseases Fellowship @IUIDfellowship

over 5 years ago

#dacryoadenitis other case reports with zoster (initial dacroadenitis f/b shingels in V1), present in 1/3rd of acanthamoeba keratitis (but no direct infection of lacrimal gland)

Indiana University Infectious Diseases Fellowship @IUIDfellowship

over 5 years ago

#dacryoadenitis also rarely reported due to pseudomonas, brucella, cysticercosis, one b/l case of blastomycosis. EBV may cause acute unilater or bilateral nonsuppurative case during mononucleosis. May results in keratoconjuctivitis sicca

Indiana University Infectious Diseases Fellowship @IUIDfellowship

over 5 years ago

#dacryoadenitis inflammation of lacrimal gland. Rare and present as acute or chronic. Acute: erythema/swellinglateral part of upper lid. May lead to preseptal or orbital cellulitis or abscess. Staph aureus is most common pathogen. Strep may also cause it

touchOPHTHALMOLOGY

@touchOPHTHALMIC

over 6 years ago

In this spotlight interview, Dr Strianese discusses monoclonal antibodies in current use and in clincal development for the treatment of #OrbitalInflammation. Read the full spotlight interview here: https://t.co/jD0DoYsWz6 #dacryoadenitis #myositis #cellulitis #OpticPerineuritis

touchOPHTHALMIC's tweet photo. In this spotlight interview, Dr Strianese discusses monoclonal antibodies in current use and in clincal development for the treatment of #OrbitalInflammation.
Read the full spotlight interview here: https://t.co/jD0DoYsWz6
#dacryoadenitis #myositis #cellulitis #OpticPerineuritis https://t.co/foEDvogOon

Annals of Int Med

@AnnalsofIM

almost 9 years ago

Case report: Interleukin-1 Inhibitors and #dacryoadenitis in adult-onset still disease. https://t.co/7IwW2LbbFy

Top Tweets for #dacryoadenitis

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