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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-09-28

AUTHORS

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

ABSTRACT

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. More... »

PAGES

419-425

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10165-011-0532-6

DOI

http://dx.doi.org/10.1007/s10165-011-0532-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1037704928

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21953287


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