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Eosinophilic granulomatosis with polyangiitis can manifest lacrimal and salivary glands swelling by granulomatous inflammation: a potential mimicker of IgG4-related disease
  1. Mitsuhiro Akiyama,
  2. Yuko Kaneko,
  3. Tsutomu Takeuchi
  1. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
  1. Correspondence to Dr Yuko Kaneko; ykaneko.z6{at}

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We read the paper by Vaglio et al in your journal with great interest.1 They reported that patients with eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, showed high serum IgG4 levels, correlating with disease activity and the extent of organ involvement.1 Since then, the association between EGPA and IgG4-related disease has been discussed by researchers.2–4 EGPA is one of the systemic vasculitis and is typically preceded by bronchial asthma, allergic rhinitis and/or sinusitis and followed by peripheral blood eosinophilia and eosinophil infiltration into organs. IgG4-related disease is an emerging disease entity characterised by high serum IgG4 levels and marked IgG4-positive plasma cell infiltration at lesions. Mikulicz disease, a prototype of IgG4-related disease, presents with enlarged lacrimal and salivary glands and often has allergic features such as asthma and chronic sinusitis. Pathogenically, T helper …

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