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Yun J, Wienholt L, Adelstein S. Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease. Asia Pac Allergy. 2014;4(3):172-6doi: 10.5415/apallergy.2014.4.3.172.
Yun, J., Wienholt, L., & Adelstein, S. (2014). Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease. Asia Pacific allergy, 4(3), 172-6. https://doi.org/10.5415/apallergy.2014.4.3.172
Yun, James, et al. "Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease." Asia Pacific allergy vol. 4,3 (2014): 172-6. doi: https://doi.org/10.5415/apallergy.2014.4.3.172
Yun J, Wienholt L, Adelstein S. Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease. Asia Pac Allergy. 2014 Jul;4(3):172-6. doi: 10.5415/apallergy.2014.4.3.172. Epub 2014 Jul 29. PMID: 25097853; PMCID: PMC4116044.
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Asia Pac Allergy. 2014 Jul;4(3):172-6. doi: 10.5415/apallergy.2014.4.3.172. Epub 2014 Jul 29.

Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease.

Asia Pacific allergy

James Yun, Louise Wienholt, Stephen Adelstein

Affiliations

  1. Department of Clinical Immunology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.

PMID: 25097853 PMCID: PMC4116044 DOI: 10.5415/apallergy.2014.4.3.172

Abstract

BACKGROUND: Immunoglobulin G4 (IgG4)-related sclerosing disease is a recently described clinicopathological entity with diverse manifestations including, amongst others, autoimmune pancreatitis, sclerosing cholangitis, sclerosing sialadenitis and retroperitoneal fibrosis. Elevated serum IgG4 concentration has been described as the hallmark of this condition with reported good sensitivity and specificity.

OBJECTIVE: We sought to establish the utility of serum IgG4 concentrations in the diagnosis of IgG4-related sclerosing disease by determining how many serum samples with elevated IgG4 from an unselected population would originate from patients who fulfilled criteria for this diagnosis.

METHODS: The clinical features and laboratory characteristics of patients whose serum IgG4 concentration was greater than 1.30 g/L were analysed retrospectively from a total of 1,258 IgG subclass measurements performed in a tertiary hospital diagnostic laboratory.

RESULTS: Eighty patients (6.4%) had elevated IgG4 concentrations greater than 1.30 g/L. Nine of 61 patients had the diagnosis of IgG4-related sclerosing disease, giving a poor positive predictive value of 15%. The median serum IgG4 concentrations of those with and without IgG4-related sclerosing disease were 2.16 g/L and 1.86 g/L, respectively (p = 0.22).

CONCLUSION: Serum IgG4 concentration has poor positive predictive value in the diagnosis of IgG4-related sclerosing disease and, therefore, the clinical significance of elevated serum IgG4 concentration alone must be interpreted with caution.

Keywords: Autoimmune diseases; Immunoglobulin G; Mikulicz' disease; Pancreatitis

References

  1. Ann Rheum Dis. 2015 Jan;74(1):14-8 - PubMed
  2. BMC Med. 2006 Oct 06;4:23 - PubMed
  3. Clin Chim Acta. 2009 Oct;408(1-2):25-8 - PubMed
  4. Am J Gastroenterol. 2007 Aug;102(8):1646-53 - PubMed
  5. Gut. 2007 Oct;56(10):1471-2 - PubMed
  6. Clin Chem. 2003 Nov;49(11):1924-9 - PubMed
  7. Intern Med. 2008;47(4):291-4 - PubMed
  8. J Gastroenterol Hepatol. 2009 Jan;24(1):15-36 - PubMed
  9. J Immunol. 1983 Feb;130(2):722-6 - PubMed
  10. N Engl J Med. 2001 Mar 8;344(10):732-8 - PubMed
  11. Scand J Rheumatol. 2004;33(6):432-3 - PubMed
  12. Curr Opin Rheumatol. 2011 Jan;23(1):18-23 - PubMed
  13. Clin Allergy. 1976 May;6(3):237-40 - PubMed
  14. Eur J Gastroenterol Hepatol. 2011 Feb;23(2):139-45 - PubMed
  15. Am J Surg Pathol. 2005 Feb;29(2):275-8 - PubMed
  16. Clin Exp Nephrol. 2007 Jun;11(2):168-173 - PubMed
  17. Int Arch Allergy Immunol. 2010;152 Suppl 1:47-53 - PubMed
  18. Pancreas. 2014 Jul;43(5):704-7 - PubMed
  19. Am J Gastroenterol. 2006 Sep;101(9):2070-5 - PubMed
  20. Am J Surg Pathol. 2009 Dec;33(12):1833-9 - PubMed
  21. Rheumatol Int. 2010 Apr;30(6):837-40 - PubMed
  22. Pancreatology. 2006;6(1-2):132-7 - PubMed

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