Serum Levels of IgG and IgG4 in Hashimoto Thyroiditis

Overview

Journal Endocrine

Specialty Endocrinology

Date 2013 May 23

PMID 23695895

Citations 9

Authors

Sachiko-Tsukamoto Kawashima

Tetsuya Tagami

Kanako Nakao

Kazutaka Nanba

Tamiko Tamanaha

Takeshi Usui

Mitsuhide Naruse

Sachiko Minamiguchi

Yusuke Mori

Jun Tsuji

Issei Tanaka

Akira Shimatsu

Affiliations

Soon will be listed here.

Abstract

Although IgG4-related disease is characterized by extensive infiltration of IgG4-positive plasma cells and lymphocytes of various organs, the details of this systemic disease are still unclear. We screened serum total IgG levels in the patients with Hashimoto thyroiditis (HT) to illustrate the prevalence of IgG4-related thyroiditis in HT. Twenty-four of 94 patients with HT (25.5%) had elevated serum IgG levels and their serum IgG4 was measured. Five of the 24 cases had more than 135 mg/dL of IgG4, which is the serum criterion of IgG4-related disease. One was a female patient who was initially treated as Graves' disease and rapidly developed a firm goiter and hypothyroidism. The biopsy of her thyroid gland revealed that follicular cells were atrophic with squamous metaplasia, replaced with fibrosis, which was compatible with the fibrous variant of HT. Immunohistochemical examination revealed diffuse infiltration of IgG4-positive plasma cells, and the serum IgG4 level was 179 mg/dL. The levels of IgG and IgG4 were positively correlated with the titers of anti-thyroglobulin antibody or anti-thyroid peroxidase antibody. In conclusion, at least a small portion of patients with HT with high titers of anti-thyroid antibodies may overlap the IgG4-related thyroiditis.

Citing Articles

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IgG4 thyroiditis in the Asian population.

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References

Harach H, Williams E . Fibrous thyroiditis--an immunopathological study. Histopathology. 1983; 7(5):739-51. DOI: 10.1111/j.1365-2559.1983.tb02286.x. View

Aalberse R, Van Milligen F, Tan K, Stapel S . Allergen-specific IgG4 in atopic disease. Allergy. 1993; 48(8):559-69. DOI: 10.1111/j.1398-9995.1993.tb00749.x. View

Hussain R, Poindexter R, Ottesen E . Control of allergic reactivity in human filariasis. Predominant localization of blocking antibody to the IgG4 subclass. J Immunol. 1992; 148(9):2731-7. View

Shimatsu A, Oki Y, Fujisawa I, Sano T . Pituitary and stalk lesions (infundibulo-hypophysitis) associated with immunoglobulin G4-related systemic disease: an emerging clinical entity. Endocr J. 2009; 56(9):1033-41. DOI: 10.1507/endocrj.k09e-277. View

Komatsu K, Hamano H, Ochi Y, Takayama M, Muraki T, Yoshizawa K . High prevalence of hypothyroidism in patients with autoimmune pancreatitis. Dig Dis Sci. 2005; 50(6):1052-7. DOI: 10.1007/s10620-005-2703-9. View

Xie L, Gao Y, Li M, Lu G, Guo X . Distribution of immunoglobulin G subclasses of anti-thyroid peroxidase antibody in sera from patients with Hashimoto's thyroiditis with different thyroid functional status. Clin Exp Immunol. 2008; 154(2):172-6. PMC: 2612718. DOI: 10.1111/j.1365-2249.2008.03756.x. View

Caturegli P, Kuppers R, Mariotti S, Burek C, Pinchera A, Ladenson P . IgG subclass distribution of thyroglobulin antibodies in patients with thyroid disease. Clin Exp Immunol. 1994; 98(3):464-9. PMC: 1534515. DOI: 10.1111/j.1365-2249.1994.tb05514.x. View

KATZ S, VICKERY JR A . The fibrous variant of Hashimoto's thyroiditis. Hum Pathol. 1974; 5(2):161-70. DOI: 10.1016/s0046-8177(74)80063-8. View

Portmann L, Hamada N, Heinrich G, DeGroot L . Anti-thyroid peroxidase antibody in patients with autoimmune thyroid disease: possible identity with anti-microsomal antibody. J Clin Endocrinol Metab. 1985; 61(5):1001-3. DOI: 10.1210/jcem-61-5-1001. View

10.

Sato Y, Notohara K, Kojima M, Takata K, Masaki Y, Yoshino T . IgG4-related disease: historical overview and pathology of hematological disorders. Pathol Int. 2010; 60(4):247-58. DOI: 10.1111/j.1440-1827.2010.02524.x. View

11.

Neild G, Rodriguez-Justo M, Wall C, Connolly J . Hyper-IgG4 disease: report and characterisation of a new disease. BMC Med. 2006; 4:23. PMC: 1618394. DOI: 10.1186/1741-7015-4-23. View

12.

Kakudo K, Li Y, Taniguchi E, Mori I, Ozaki T, Nishihara E . IgG4-related disease of the thyroid glands. Endocr J. 2011; 59(4):273-81. DOI: 10.1507/endocrj.ej11-0309. View

13.

Punnonen J, Aversa G, Cocks B, McKenzie A, Menon S, Zurawski G . Interleukin 13 induces interleukin 4-independent IgG4 and IgE synthesis and CD23 expression by human B cells. Proc Natl Acad Sci U S A. 1993; 90(8):3730-4. PMC: 46375. DOI: 10.1073/pnas.90.8.3730. View

14.

Torrigiani G, Roitt I, Doniach D . Quantitative distribution of human thyroglobulin autoantibodies in different immunoglobulin classes. Clin Exp Immunol. 1968; 3(7):621-30. PMC: 1578988. View

15.

Jones C, Hamilton R, Jordon R . Subclass distribution of human IgG autoantibodies in pemphigus. J Clin Immunol. 1988; 8(1):43-9. DOI: 10.1007/BF00915155. View

16.

Zen Y, Kitagawa S, Minato H, Kurumaya H, Katayanagi K, Masuda S . IgG4-positive plasma cells in inflammatory pseudotumor (plasma cell granuloma) of the lung. Hum Pathol. 2005; 36(7):710-7. DOI: 10.1016/j.humpath.2005.05.011. View

17.

Deshpande V, Zen Y, Chan J, Yi E, Sato Y, Yoshino T . Consensus statement on the pathology of IgG4-related disease. Mod Pathol. 2012; 25(9):1181-92. DOI: 10.1038/modpathol.2012.72. View

18.

Li Y, Zhou G, Ozaki T, Nishihara E, Matsuzuka F, Bai Y . Distinct histopathological features of Hashimoto's thyroiditis with respect to IgG4-related disease. Mod Pathol. 2012; 25(8):1086-97. DOI: 10.1038/modpathol.2012.68. View

19.

Pusztaszeri M, Triponez F, Pache J, Bongiovanni M . Riedel's thyroiditis with increased IgG4 plasma cells: evidence for an underlying IgG4-related sclerosing disease?. Thyroid. 2012; 22(9):964-8. DOI: 10.1089/thy.2011.0404. View

20.

Guo J, Jaume J, Rapoport B, McLachlan S . Recombinant thyroid peroxidase-specific Fab converted to immunoglobulin G (IgG) molecules: evidence for thyroid cell damage by IgG1, but not IgG4, autoantibodies. J Clin Endocrinol Metab. 1997; 82(3):925-31. DOI: 10.1210/jcem.82.3.3831. View