RT Journal Article SR Electronic 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 FD Royal College of Physicians SP e32 OP e39 DO 10.7861/clinmed.2019-0457 VO 20 IS 3 A1 George Goodchild A1 Rory JR Peters A1 Tamsin N Cargill A1 Harry Martin A1 Adetokunbo Fadipe A1 Maria Leandro A1 Adam Bailey A1 Jane Collier A1 Louisa Firmin A1 Manil Chouhan A1 Manuel Rodriguez-Justo A1 Ross Sadler A1 Roger W Chapman A1 Helen Bungay A1 Eve Fryer A1 Joel David A1 Raashid Luqmani A1 Eleanor Barnes A1 George J Webster A1 Emma L Culver YR 2020 UL http://www.rcpjournals.org/content/20/3/e32.abstract AB 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