Clinicopathological characteristics of gastric IgG4‐related disease: Systematic scoping review

• DOI: 10.1111/jgh.15980
• Publication Date: 2022-08-11T04:43:15Z
• Authors: Haruki Sawada; Torrey Czech; Krixie Silangcruz; Landon Kozai; Adham Obeidat; Eric Andrew Wien; Midori Filiz Nish...; Asami Nishikori; Yasuharu Sato; Yoshito Nishimura
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Gastrointestinal Stromal Tumors; Stomach Neoplasms; Immunoglobulin G; Humans; Immunoglobulin G4-Related Disease; Ulcer; 3. Good health

AbstractBackground and AimGastric IgG4‐related disease (IgG4‐RD) can mimic malignancy, submucosal tumors (SMT), and ulcers, leading to over‐triage and unnecessary medical interventions such as gastrectomy. The variability in the clinicopathological presentation of IgG4‐related disease is not yet well defined, posing a diagnostic challenge.MethodsFollowing the PRISMA Extension for Scoping Reviews, we searched MEDLINE and EMBASE for all peer‐reviewed articles using keywords including “gastritis,” “stomach,” “gastrointestinal stromal tumor,” and “IgG4‐RD” from their inception to December 28, 2021.ResultsThirty‐nine articles, including 2 observational studies and 42 cases, were included in the systematic review. While bottom‐heavy lymphoplasmacytic mucosal infiltration is a characteristic finding of gastric IgG4‐RD, it was only present in less than half of the patients in the observational studies. Patients with gastric IgG4‐RD were more likely to be diagnosed with gastrointestinal stromal tumor (GIST), gastric cancer, or peptic ulcer disease and their clinical course involved resection (51.3%) or even gastrectomy. Diagnosis of gastric IgG4‐RD was most frequently made by post‐operative pathological analysis.ConclusionThis systematic review summarizes the current understanding of the characteristics of gastric IgG4‐RD. Increased awareness of gastric IgG4‐RD as a differential diagnosis of gastric SMT or ulcers among clinicians is crucial in order to reduce unnecessary high‐risk, invasive interventions.