Clinical characteristics of Mikulicz's disease as an IgG4-related disease

Masafumi Moriyama, Akihiko Tanaka, Takashi Maehara, Yukiko Ohyama, Mayumi Shimizu, Hitoshi Nakashima, Jun Nosuke Hayashida, Shoichi Shinozaki, Yoshiaki Kubo, Sachiko Furukawa, Toshihiro Kikuta, Seiji Nakamura

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Objectives: Mikulicz's disease (MD) was considered to be a subtype of Sjögren's syndrome (SS), based on histopathological similarities. However, recent studies have indicated that patients with MD show high serum IgG4 concentration, and suggested that MD is one of "IgG4-related disease" and distinguishable from SS. Therefore, we clinically and histopathologically examined the disease states of MD and SS in detail. Materials and methods: Twenty patients with Mikulicz's disease and 18 with SS were comparatively studied to determine clinical characteristics in MD patients. Results: Sialography in MD patients did not show the "apple-tree sign" typically seen in SS. Serologically, high serum IgG4 levels but not anti-SS-A or anti-SS-B antibodies were observed in MD. SS showed lymphocytic infiltration of various subsets with atrophy or severe destruction of the acini, while MD showed selective infiltration of IgG4+ plasma cells with hyperplastic germinal centers and mild acini destruction. Corticosteroid treatment of MD reduced IgG and IgG4 levels and improved salivary function. A negative correlation between disease duration and increasing rate of salivary flow was observed in MD. Conclusions: These results suggested that the pathogenesis of MD might be different from those of SS. Clinical Relevance: early diagnosis and treatment of MD is important for the improvement of salivary function.

Original languageEnglish
Pages (from-to)1995-2002
Number of pages8
JournalClinical Oral Investigations
Issue number9
Publication statusPublished - Dec 2013

All Science Journal Classification (ASJC) codes

  • General Dentistry


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