Establishment of a serum IgG4 cut-off value for the differential diagnosis of IgG4-related disease in Chinese population

Mod Rheumatol. 2016 Jul;26(4):583-7. doi: 10.3109/14397595.2015.1117171. Epub 2015 Dec 23.

Abstract

Objective: This study was performed to better know diagnosis associated with serum IgG4 concentration, and to explore the possibility for development of a serum IgG4 for IgG4-related disease (IgG4-RD) in Chinese populations.

Methods: We studied retrospectively 497 IgG4 serum subclass measurements from Peking Union Medical College Hospital during the four-year period, including 242 IgG4-RD, 130 other diseases and 125 healthy individuals.

Results: Serum IgG4 concentrations were significantly higher in IgG4-RD than in other pathologies (1662.9 ± 3760.9 mg/L, p < 0.001) and healthy individuals (538.2 ± 458.6 mg/L, p < 0.001). There were no significant differences in serum IgG4 level between other pathologies group and healthy individuals (p = 0.075). Among the 242 IgG4-RD patients analyzed, serum IgG4 concentrations were normal in 46 patients (19.0%). We found 32 patients (24.6%) with elevated serum IgG4 levels among the 130 patients who suffered from other pathologies. There were seven (5.6%) with serum IgG4 over 1350 mg/L in healthy individuals. The ROC curve analysis revealed that the optimal sensitivity and specificity were 80.0% and 88.2%, respectively, at the concentration of 1575 mg/L for Chinese patients.

Conclusions: Our study demonstrated that serum IgG4 elevation was not specific of IgG4-RD. Further studies are needed to define the sensibility and specificity of IgG4 values for the diagnosis of IgG4-RD.

Keywords: Cut-off values; IgG4-related disease; Receiver operating characteristic; Serum immunoglobulin G4 concentrations; Standard deviation.

MeSH terms

  • Adult
  • Aged
  • China / epidemiology
  • Diagnosis, Differential
  • Female
  • Humans
  • Immune System Diseases* / blood
  • Immune System Diseases* / diagnosis
  • Immune System Diseases* / epidemiology
  • Immunoglobulin G* / analysis
  • Immunoglobulin G* / blood
  • Male
  • Middle Aged
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Immunoglobulin G