In three patients with immunoglobulin G4-related dacryoadenitis and sialoadenitis (IgG4-DS), we assessed the changes in the hardness of affected submandibular glands by the real-time tissue elastography at baseline and 2 weeks after the initiation of treatment with oral glucocorticoids. Elastography revealed "blue" meaning to be a hard tissue matched the hypoechoic areas inside the enlarged submandibular glands before treatment. The stiff elastographic changes rapidly improved after 2 weeks. This may relate with the reversibility of salivary function by glucocorticoid treatment in patients with IgG4-DS.
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