Singh N, Anzalone AJ, Stevenson H, Robinson L, Jackson LE, Safo SE, Butzin-Dozier Z, Michaud K, Danila MI, Singh JA, Patel RC; National Clinical Cohort Collaborative (N3C) Consortium. Higher risk of Long COVID among patients with autoimmune rheumatic diseases and immunomodulatory therapy: a retrospective cohort analysis of national US data. Arthritis Rheumatol. 2026 Oct 14. doi: 10.1002/art.70361IF: 9.9 Q1 .
這篇研究特別值得注意的是,研究者不只是比較一般人與自體免疫疾病患者的差異,也進一步分析了不同風濕免疫疾病及感染前使用藥物的影響。其中,修格蘭氏症(Sjögren's syndrome)與較高的 Long COVID 風險有關,是相當值得臨床醫師關注的發現。
臺北榮民總醫院傳統醫學部張清貿醫師團隊曾在國際期刊QJM發表一例以中醫藥整合治療IgG4相關硬化性腸繫膜炎(IgG4-related sclerosing mesenteritis)之病例報告(Integrated
therapy reduces serum IgG4 in patients with IgG4-related sclerosing
mesenteritis: a case report) [1]。患者為61歲男性,主訴持續腹瀉、食慾不振、餐後腹脹及體重明顯減輕,病程已持續2個月。儘管初期接受口服類固醇治療,血清IgG4濃度仍由1080 mg/dL上升至1240 mg/dL,病情無明顯改善,遂改採整合中醫藥治療策略。
IgG4-Related Disease Explained: Integrative Medicine, Immunity, and Chinese Medicine | Ching-Mao Chang, MD, PhD
What is IgG4-related disease (IgG4-RD), and why can it affect so many different organs throughout the body?
In this English podcast episode, I introduce IgG4-related disease, a relatively newly recognized systemic immune-mediated condition characterized by chronic inflammation, organ enlargement, and, in some patients, progressive fibrosis.
Rather than discussing IgG4-RD only from the perspective of a single organ or specialty, I approach the disease from the standpoint of integrative medicine, bringing together modern immunology, conventional medical treatment, Traditional Chinese Medicine (TCM), and my own clinical and research experience.
中醫自體免疫暨乾眼症客觀量測實驗室 (Traditional Chinese medicine Autoimmune Disease and Dry Eye Syndrome Objective Measurements Lab,AIDDES Lab)致力於結合中醫理論與現代科技,進行前瞻性的研究,探索自體免疫風溼疾病與乾眼症患者的病理機轉及中醫輔助治療。AIDDES實驗室聚焦於透過客觀量測訊號,如中醫體質、舌診、脈診、虹膜、甲褶及心律變異等,加上DNA、RNA、蛋白質體學、口腔微生物菌相等生物醫學指標,深入探討客觀與生物醫學指標與自體免疫疾病的相關性,並進行跨領域的研究,以期建立更科學且精確的診斷與治療方法。
美國風溼病學會(American College of Rheumatology,ACR)和歐洲風溼病醫學會(European League Against Rheumatism,EULAR)已於2019年制定IgG4-RD的分類標準,受影響器官必須包含十一個器官中的至少一項,分別為胰臟、膽管、眼窩、淚腺、大唾腺、肺臟、腎臟、主動脈、後腹膜、硬腦膜以及甲狀腺;此外,相關病理檢查結果亦納入分類架構,顯示單一指標無法作為唯一診斷標準[12-16]。然而,IgG4-RD與其他纖維性發炎疾病在臨床表現上仍有高度重疊,故其診斷在實務上仍具相當挑戰性。ACR/EULAR分類標準的重要性不僅在於提高一致性,更在於提醒臨床醫師:IgG4-RD本質上是一個需要整合器官表現、組織病理與免疫資訊的系統性疾病。