TY - JOUR T1 - Experience from the first UK inter-regional specialist multidisciplinary meeting in the diagnosis and management of IgG4-related disease JF - Clinical Medicine JO - Clin Med SP - e32 LP - e39 DO - 10.7861/clinmed.2019-0457 VL - 20 IS - 3 AU - George Goodchild AU - Rory JR Peters AU - Tamsin N Cargill AU - Harry Martin AU - Adetokunbo Fadipe AU - Maria Leandro AU - Adam Bailey AU - Jane Collier AU - Louisa Firmin AU - Manil Chouhan AU - Manuel Rodriguez-Justo AU - Ross Sadler AU - Roger W Chapman AU - Helen Bungay AU - Eve Fryer AU - Joel David AU - Raashid Luqmani AU - Eleanor Barnes AU - George J Webster AU - Emma L Culver Y1 - 2020/05/01 UR - http://www.rcpjournals.org/content/20/3/e32.abstract N2 - Immunoglobulin G4-related disease (IgG4-RD) is a complex multisystem fibro-inflammatory disorder, requiring diagnostic differentiation from malignancy and other immune-mediated conditions, and careful management to minimise glucocorticoid-induced toxicity and prevent progressive organ dysfunction. We describe the experience of the first inter-regional specialist IgG4-RD multidisciplinary team meeting (MDM) incorporating a broad range of generalists and specialists, held 6-weekly via web-link between Oxford University Hospitals NHS Foundation Trust and University College London Hospitals NHS Foundation Trust. Over 3 years, there were 206 discussions on 156 patients. Of these, 97 (62%) were considered to have definite or possible IgG4-RD; 67% had multi-organ involvement and 23% had a normal serum IgG4. The average number of specialist opinions sought prior to MDM was four per patient. Management was changed in the majority of patients (74%) with the treatment escalation recommended in 61 cases, including 19 for rituximab. Challenges arose from delays and misdiagnosis, cross-specialty presentation and the management of sub-clinical disease. Our cross-discipline IgG4-RD MDM enabled important diagnostic and management decisions in this complex multisystem disorder, and can be used as a model for other centres in the UK ER -