Masaki et al reported criteria for IgG4-related Mikulicz's disease.The authors are from Kanazawa Medical University in Ishikawa, Japan.
Criteria for IgG4-related Mikulicz's disease:
(1) symmetrical swelling of 2 or more pairs of salivary glands (lacrimal, parotid, submandibular) for > 3 months.
(2) serum IgG4 elevated (> 135 mg/dL)
(3) histologic changes in affected salivary glands
(3a) lymphocytes
(3b) IgG4-positive plasma cells (positive staining in > 50% of plasma cells)
(3c) typical fibrosis or sclerosis
The diagnosis also requires exclusion of other disorders affecting salivary glands: sarcoidosis, malignant lymphoma, Casteleman's disease, Wegener's granulomatosis; carcinoma.
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