Roles of IgG4 and IgG4/IgG Ratio to IgG4-related Disease in Patients with Elevated Serum IgG4 Level

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2022 Oct 28

PMID 36305979

Authors

Hai Wang

Chunling Wang

Qin Wan

Li Li

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the performance of elevated serum IgG4 and IgG4/IgG in IgG4-related disease (IgG4-RD) and other diseases.

Methods: Seven hundred seventy-three patients with elevated serum IgG4 level (> 2.01 g/L) were reviewed in Zhongda Hospital of Southeast University from 1 July 2016 to 31 December 2021. Demographic, disease distribution and the role of elevated serum IgG4 and IgG4/IgG in IgG4-RD and other diseases were analysed. The alteration of IgG4 and IgG4/IgG in pre-therapy and post-treatment were also assessed in IgG4-RD.

Results: Patients with elevated serum IgG4 were principally observed in older males. Chronic diseases of various organs (21.7%), rheumatic immune diseases (19.4%), bacterial infection disease (11.5%) and malignant tumor (5.2%) were the common diseases with elevated serum IgG4, but only 3.2% was IgG4-RD. The level of IgG4 and IgG4/IgG in IgG4-RD was significantly higher than that in various diseases except for eosinophilia group. Serum IgG4 and IgG4/IgG manifested a similar diagnostic capacity for IgG4-RD among this study cohort and the optimal cut-off values were 3.345 g/L and 0.295 respectively. The sensitivity and specificity were 96% and 71% for the optimal cut-off value of IgG4, and 80% and 88.8% for the optimal cut-off value of IgG4/IgG4. IgG4 and IgG4/IgG both were remarkably reduced in IgG4-RD after therapy compared with prior treatment (P < 0.05).

Conclusions: Elevated serum IgG4 was found in a variety of diseases, especially in chronic diseases of various organs. IgG4 and IgG4/IgG manifest a great value for IgG4-RD diagnosis, and are available for the treatment evaluation of IgG4-RD. Key Points • Elevated serum IgG4 level was not a specific marker to IgG4-related disease and can be observed in various diseases. • Patients with IgG4-related disease or eosinophilia manifest a higher level of serum IgG4 and IgG4/IgG. • Both of IgG4 and IgG4/IgG are available for the diagnosis and the clinical treatment evaluation of IgG4-related disease.

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