Abstract

Objective: To differentiate patients with IgG4-related diseases (RD) from patients with other hyper IgG4 conditions who visit general medicine department. Methods: Fifty-six patients with high serum IgG4 levels (>135 mg/dL) were classified into three groups based on the final diagnosis: definite and possible IgG4-RD and others. Clinical and laboratory characteristics of the three groups of patients were retrospectively analyzed. Results: Major manifestations were renal dysfunction and general malaise, while thirst was the most frequent symptom in the definite group, in which submandibular glands and lymph nodes were likely to be affected. Biopsy of minor salivary glands was the least diagnostic for IgG4-RD despite the high frequency of biopsy. In the definite group, serum levels of IgG4 and IgG, IgG4/IgG ratio and basophil number were increased, while serum levels of CRP, IgA and complements were decreased. A negative correlation between serum levels of IgG4 and IgM was found in the definite group. Conclusion: The results indicated that in patients with renal dysfunction, malaise, thirst or weight loss, measurements of the levels of basophils, immunoglobulins and complements are helpful for diagnosing IgG4-RD. Considering distribution of affected tissues and localization of diagnostic biopsies, physical examination and laboratory workup are required for early diagnosis.

Original languageEnglish
JournalModern Rheumatology
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Immunoglobulin G
Serum
Thirst
Basophils
Biopsy
Minor Salivary Glands
Kidney
Submandibular Gland
Tissue Distribution
Immunoglobulin A
Physical Examination
Immunoglobulin M
Immunoglobulins
Weight Loss
Early Diagnosis
Lymph Nodes
Medicine

Keywords

  • Complements
  • IgG4-related disease (IgG4-RD)
  • immunoglobulin
  • immunoglobulin G subclass 4 (IgG4)

ASJC Scopus subject areas

  • Rheumatology

Cite this

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title = "Clinical and biochemical characteristics of patients having general symptoms with increased serum IgG4",
abstract = "Objective: To differentiate patients with IgG4-related diseases (RD) from patients with other hyper IgG4 conditions who visit general medicine department. Methods: Fifty-six patients with high serum IgG4 levels (>135 mg/dL) were classified into three groups based on the final diagnosis: definite and possible IgG4-RD and others. Clinical and laboratory characteristics of the three groups of patients were retrospectively analyzed. Results: Major manifestations were renal dysfunction and general malaise, while thirst was the most frequent symptom in the definite group, in which submandibular glands and lymph nodes were likely to be affected. Biopsy of minor salivary glands was the least diagnostic for IgG4-RD despite the high frequency of biopsy. In the definite group, serum levels of IgG4 and IgG, IgG4/IgG ratio and basophil number were increased, while serum levels of CRP, IgA and complements were decreased. A negative correlation between serum levels of IgG4 and IgM was found in the definite group. Conclusion: The results indicated that in patients with renal dysfunction, malaise, thirst or weight loss, measurements of the levels of basophils, immunoglobulins and complements are helpful for diagnosing IgG4-RD. Considering distribution of affected tissues and localization of diagnostic biopsies, physical examination and laboratory workup are required for early diagnosis.",
keywords = "Complements, IgG4-related disease (IgG4-RD), immunoglobulin, immunoglobulin G subclass 4 (IgG4)",
author = "Kou Hasegawa and Yoshihisa Hanayama and Mikako Obika and Tomoko Miyoshi and Hiroko Ogawa and Eisei Kondo and Hitomi Kataoka and Yasuharu Sato and Fumio Otsuka",
year = "2019",
month = "1",
day = "1",
doi = "10.1080/14397595.2019.1642291",
language = "English",
journal = "Modern Rheumatology",
issn = "1439-7595",
publisher = "Springer Japan",

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T1 - Clinical and biochemical characteristics of patients having general symptoms with increased serum IgG4

AU - Hasegawa, Kou

AU - Hanayama, Yoshihisa

AU - Obika, Mikako

AU - Miyoshi, Tomoko

AU - Ogawa, Hiroko

AU - Kondo, Eisei

AU - Kataoka, Hitomi

AU - Sato, Yasuharu

AU - Otsuka, Fumio

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To differentiate patients with IgG4-related diseases (RD) from patients with other hyper IgG4 conditions who visit general medicine department. Methods: Fifty-six patients with high serum IgG4 levels (>135 mg/dL) were classified into three groups based on the final diagnosis: definite and possible IgG4-RD and others. Clinical and laboratory characteristics of the three groups of patients were retrospectively analyzed. Results: Major manifestations were renal dysfunction and general malaise, while thirst was the most frequent symptom in the definite group, in which submandibular glands and lymph nodes were likely to be affected. Biopsy of minor salivary glands was the least diagnostic for IgG4-RD despite the high frequency of biopsy. In the definite group, serum levels of IgG4 and IgG, IgG4/IgG ratio and basophil number were increased, while serum levels of CRP, IgA and complements were decreased. A negative correlation between serum levels of IgG4 and IgM was found in the definite group. Conclusion: The results indicated that in patients with renal dysfunction, malaise, thirst or weight loss, measurements of the levels of basophils, immunoglobulins and complements are helpful for diagnosing IgG4-RD. Considering distribution of affected tissues and localization of diagnostic biopsies, physical examination and laboratory workup are required for early diagnosis.

AB - Objective: To differentiate patients with IgG4-related diseases (RD) from patients with other hyper IgG4 conditions who visit general medicine department. Methods: Fifty-six patients with high serum IgG4 levels (>135 mg/dL) were classified into three groups based on the final diagnosis: definite and possible IgG4-RD and others. Clinical and laboratory characteristics of the three groups of patients were retrospectively analyzed. Results: Major manifestations were renal dysfunction and general malaise, while thirst was the most frequent symptom in the definite group, in which submandibular glands and lymph nodes were likely to be affected. Biopsy of minor salivary glands was the least diagnostic for IgG4-RD despite the high frequency of biopsy. In the definite group, serum levels of IgG4 and IgG, IgG4/IgG ratio and basophil number were increased, while serum levels of CRP, IgA and complements were decreased. A negative correlation between serum levels of IgG4 and IgM was found in the definite group. Conclusion: The results indicated that in patients with renal dysfunction, malaise, thirst or weight loss, measurements of the levels of basophils, immunoglobulins and complements are helpful for diagnosing IgG4-RD. Considering distribution of affected tissues and localization of diagnostic biopsies, physical examination and laboratory workup are required for early diagnosis.

KW - Complements

KW - IgG4-related disease (IgG4-RD)

KW - immunoglobulin

KW - immunoglobulin G subclass 4 (IgG4)

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