Details

Autor(en) / Beteiligte

• Yamamoto, Motohisa
• Tabeya, Tetsuya
• Naishiro, Yasuyoshi
• Yajima, Hidetaka
• Ishigami, Keisuke
• Shimizu, Yui
• Obara, Mikiko
• Suzuki, Chisako
• Yamashita, Kentaro
• Yamamoto, Hiroyuki
• Hayashi, Toshiaki
• Sasaki, Shigeru
• Sugaya, Toshiaki
• Ishida, Tadao
• Takano, Ken-ichi
• Himi, Tetsuo
• Suzuki, Yasuo
• Nishimoto, Norihiro
• Honda, Saho
• Takahashi, Hiroki
• Imai, Kohzoh
• Shinomura, Yasuhisa

Titel

Value of serum IgG4 in the diagnosis of IgG4-related disease and in differentiation from rheumatic diseases and other diseases

Ist Teil von

• Modern rheumatology, 2012-06, Vol.22 (3), p.419-425

Ort / Verlag

Japan: Springer Japan

Erscheinungsjahr

2012

Quelle

2022 ECC(Springer)

Beschreibungen/Notizen

• IgG4-related disease (IgG4-RD) is a novel disease entity that includes Mikulicz’s disease, autoimmune pancreatitis (AIP), and many other conditions. It is characterized by elevated serum IgG4 levels and abundant IgG4-bearing plasmacyte infiltration of involved organs. We postulated that high levels of serum IgG4 would comprise a useful diagnostic tool, but little information is available about IgG4 in conditions other than IgG4-RD, including rheumatic diseases. Several reports have described cutoff values for serum IgG4 when diagnosing IgG4-RD, but these studies mostly used 135 mg/dL in AIP to differentiate from pancreatic cancer instead of rheumatic and other common diseases. There is no evidence for a cutoff serum IgG4 level of 135 mg/dL for rheumatic diseases and common diseases that are often complicated with rheumatic diseases. The aim of this work was to re-evaluate the usual cutoff serum IgG4 value in AIP (135 mg/dL) that is used to diagnose whole IgG4-RD in the setting of a rheumatic clinic by measuring serum IgG4 levels in IgG4-RD and various disorders. We therefore constructed ROC curves of serum IgG4 levels in 418 patients who attended Sapporo Medical University Hospital due to IgG4-RD and various rheumatic and common disorders. The optimal cut-off value of serum IgG4 for a diagnosis of IgG4-RD was 144 mg/dL, and the sensitivity and specificity were 95.10 and 90.76%, respectively. Levels of serum IgG4 were elevated in IgG4-RD, Churg–Strauss syndrome, multicentric Castleman’s disease, eosinophilic disorders, and in some patients with rheumatoid arthritis, systemic sclerosis, chronic hepatitis, and liver cirrhosis. The usual cut-off value of 135 mg/dL in AIP is useful for diagnosing whole IgG4-RD, but high levels of serum IgG4 are sometimes observed in not only IgG4-RD but also other rheumatic and common diseases.