Proposal of diagnostic criteria for IgG4-related thyroid disease

Patients with IgG4-related disease (IgG4-RD) are diagnosed in Japan by comprehensive or organ-specific diagnostic criteria. To date, criteria have been established for several organs, but not the thyroid. We attempted to establish thyroid (IgG4-RTD) based on IgG4-RD research The Research Program Intractable Diseases from Ministry of Health, Labour and Welfare Japan. These publicly reported members both Endocrine Society Thyroid Association. diseases associated IgG4 include Hashimoto’s thyroiditis, Graves’ Riedel’s thyroiditis. As a definition that includes systematic forms, we use broad term ‘IgG4-related disease’. Diagnostic IgG4-RTD comprise following five items: I) enlargement thyroid, II) hypoechoic lesions ultrasonography, III) elevated serum levels, IV) histopathological findings lesion (IgG4+ plasma cells >20/HPF IgG4+/IgG+ cell ratio >30%) V) involvement other organs. “Definitive” diagnosis is made when I, II, III IV all fulfilled, while “probable” V fulfilled. who fulfill II considered as “possible” IgG4-RTD. believe proposed contribute more accurate well exclusion mimicry. Furthermore, they may lead better understanding clinical implications underlying pathogenesis