Cutoff Values of Serum IgG4 and Histopathological IgG4+ Plasma Cells for Diagnosis of Patients with IgG4-Related Disease. (10th May 2012)

• Record Type: Journal Article
• Authors: Masaki, Yasufumi; Kurose, Nozomu; Yamamoto, Motohisa; Takahashi, Hiroki; Saeki, Takako; Azumi, Atsushi; Nakada, Shinji; Matsui, Shoko; Origuchi, Tomoki; Nishiyama, Susumu; Yamada, Kazunori; Kawano, Mitsuhiro; Hirabayashi, Akira; Fujikawa, Keita; Sugiura, Tomoko; Horikoshi, Masanobu; Umeda, Naoto; Minato, Hiroshi; Nakamura, Takuji; Iwao, Haruka; Nakajima, Akio; Miki, Miyuki; Sakai, Tomoyuki; Sawaki, Toshioki; Kawanami, Takafumi; Fujita, Yoshimasa; Tanaka, Masao; Fukushima, Toshihiro; Eguchi, Katumi; Sugai, Susumu; Umehara, Hisanori;
• Other Names: Stone John H. Academic Editor.
• Is Part Of: International journal of rheumatology. Volume 2012(2012)
• Publication Date: 2012-05-10
• Subjects: Rheumatology -- Periodicals; Rheumatology; Rheumatology; Electronic journals; Periodicals; Periodicals; 616.723
• DOI: 10.1155/2012/580814
• Languages: English
• ISSNs: 1687-9260

Abstract

Abstract : IgG4-related disease is a new disease classification established in Japan in the 21st century. Patients with IgG4-related disease display hyper-IgG4-gammaglobulinemia, massive infiltration of IgG4+ plasma cells into tissue, and good response to glucocorticoids. Since IgG4 overexpression is also observed in other disorders, it is necessary to diagnose IgG4-related disease carefully and correctly. We therefore sought to determine cutoff values for serum IgG4 and IgG4/IgG and for IgG4+/IgG+ plasma cells in tissue diagnostic of IgG4-related disease. Patients and Methods . We retrospectively analyzed serum IgG4 concentrations and IgG4/IgG ratio and IgG4+/IgG+ plasma cell ratio in tissues of 132 patients with IgG4-related disease and 48 patients with other disorders. Result . Serum IgG4 >135 mg/dl demonstrated a sensitivity of 97.0% and a specificity of 79.6% in diagnosing IgG4-related disease, and serum IgG4/IgG ratios >8% had a sensitivity and specificity of 95.5% and 87.5%, respectively. IgG4+cell/IgG+ cell ratio in tissues >40% had a sensitivity and specificity of 94.4% and 85.7%, respectively. However, the number of IgG4+ cells was reduced in severely fibrotic parts of tissues. Conclusion . Although a recent unanimous consensus of all relevant researchers in Japan recently established the diagnostic criteria for IgG4-related disease, findings such as ours indicate that further discussion is needed.