International Journal of Rheumatology (Jan 2012)
Cutoff Values of Serum IgG4 and Histopathological IgG4+ Plasma Cells for Diagnosis of Patients with IgG4-Related Disease
- Yasufumi Masaki,
- Nozomu Kurose,
- Motohisa Yamamoto,
- Hiroki Takahashi,
- Takako Saeki,
- Atsushi Azumi,
- Shinji Nakada,
- Shoko Matsui,
- Tomoki Origuchi,
- Susumu Nishiyama,
- Kazunori Yamada,
- Mitsuhiro Kawano,
- Akira Hirabayashi,
- Keita Fujikawa,
- Tomoko Sugiura,
- Masanobu Horikoshi,
- Naoto Umeda,
- Hiroshi Minato,
- Takuji Nakamura,
- Haruka Iwao,
- Akio Nakajima,
- Miyuki Miki,
- Tomoyuki Sakai,
- Toshioki Sawaki,
- Takafumi Kawanami,
- Yoshimasa Fujita,
- Masao Tanaka,
- Toshihiro Fukushima,
- Katumi Eguchi,
- Susumu Sugai,
- Hisanori Umehara
Affiliations
- Yasufumi Masaki
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Nozomu Kurose
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Motohisa Yamamoto
- First Department of Internal Medicine, School of Medicine, Sapporo Medical University, S1 W17 Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
- Hiroki Takahashi
- First Department of Internal Medicine, School of Medicine, Sapporo Medical University, S1 W17 Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
- Takako Saeki
- Department of Internal Medicine, Nagaoka Red Cross Hospital, Sensyu-2 297-1, Nagaoka-shi, Niigata 940-2085, Japan
- Atsushi Azumi
- Ophthalmology Department, Kobe Kaisei Hospital, Shinohara Kitamachi 3-11-15, Nada Ku, Kobe City, Hyogo 657-0068, Japan
- Shinji Nakada
- Department of Japanese Oriental Medicine, University of Toyama, 2630 Sugitani, Toyama city, Toyama 930-0194, Japan
- Shoko Matsui
- First Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama city, Toyama 930-0194, Japan
- Tomoki Origuchi
- Nagasaki Graduate School of Health Sciences, 1-7-1 Sakamoto, Nagasaki city, Nagasaki 852-8501, Japan
- Susumu Nishiyama
- Rheumatic Disease Center, Kurashiki Medical Center, 250 Bakuro-chou, Kurashiki, Okayama 710-8522, Japan
- Kazunori Yamada
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
- Mitsuhiro Kawano
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
- Akira Hirabayashi
- Hiroshima Bay Clinic, 2-2-19 Yanoshin-machi, Aki-ku, Hiroshima city, Hiroshima 736-0084, Japan
- Keita Fujikawa
- Department of Internal Medicine, Isahaya General Hospital, 24-1 Eishohigasi-macki, Isahaya, Nagasaki 854-8501, Japan
- Tomoko Sugiura
- Sugiura Clinic, 2-8-3 Imaichi-chou, Kitashin-machi, Izumo, Shimane 693-0002, Japan
- Masanobu Horikoshi
- Department of Rheumatology, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
- Naoto Umeda
- Department of Rheumatology, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
- Hiroshi Minato
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Takuji Nakamura
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Haruka Iwao
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Akio Nakajima
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Miyuki Miki
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Tomoyuki Sakai
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Toshioki Sawaki
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Takafumi Kawanami
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Yoshimasa Fujita
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Masao Tanaka
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Toshihiro Fukushima
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Katumi Eguchi
- Nagasaki Graduate School of Health Sciences, 1-7-1 Sakamoto, Nagasaki city, Nagasaki 852-8501, Japan
- Susumu Sugai
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- Hisanori Umehara
- Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan
- DOI
- https://doi.org/10.1155/2012/580814
- Journal volume & issue
-
Vol. 2012
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.
