Definite IgG4-related disease had no overlap with eosinophilic granulomatosis with polyangiitis in Korean patients: a pi
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ORIGINAL ARTICLE
Definite IgG4-related disease had no overlap with eosinophilic granulomatosis with polyangiitis in Korean patients: a pilot study in one centre Juyoung Yoo 1 & Jason Jungsik Song 1,2 & Yong-Beom Park 1,2 & Sang-Won Lee 1,2 Received: 1 February 2020 / Revised: 9 March 2020 / Accepted: 16 April 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objectives Serum IgG4 may often increases in allergic diseases. Eosinophilic granulomatosis with polyangiitis (EGPA) has an allergic phase. For this reason, it was questionable whether IgG4-RD and EGPA may share some clinical and laboratory features. In this study, we investigated whether definite IgG4-RD might share those features with EGPA. Methods We retrospectively reviewed the medical records of 42 Korean immunosuppressive drug-naïve patients with definite IgG4-RD. The American College of Rheumatology 1990 criteria for classification (the 1990 ACR criteria) for Churg-Strauss syndrome (CSS, known as EGPA) were applied to patients who were previously diagnosed with definite IgG4-RD and had no antineutrophil cytoplasmic antibody (ANCA). Definite IgG4-RD was defined when 3 components of the comprehensive diagnostic criteria were met. Results The median age of 42 patients was 61.0 years and 69% of them were men. The median serum IgG4 level was 379.0 mg/ dL and the median IgG4+/IgG+ cells ratio was 50.0%. The most common biopsy site was the salivary gland (14.3%). Antinuclear antibody was detected in 6 patients, and test results for ANCA were negative in all patients. Among 42 patients with definite IgG4-RD without ANCA, none of them met the 1990 ACR classification criteria for EGPA. Conclusions Definite IgG4-RD found to have no overlap with EGPA when the 1990 ACR criteria for CCS were applied to Korean patients. Key Points • None of 42 Korean patients with definite IgG4-RD without ANCA met the 1990 ACR classification criteria for EGPA. • Definite IgG4-RD found to have no overlap with EGPA in Korean patients without ANCA.
Keywords Eosinophilic granulomatosis with polyangiitis . IgG4-related disease . Overlap
Introduction IgG4-related disease (IgG4-RD) is a systemic inflammatory and fibrotic disease characterized by an increase in the serum IgG4 concentration and a distinct infiltrate enriched with IgG4+ plasma cells [1]. The comprehensive diagnostic criteria
* Sang-Won Lee [email protected] 1
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun–gu, Seoul 03722, Republic of Korea
2
Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
for IgG4-RD, proposed by the team of Umehara and Okazaki in 2011, are widely used. These criteria have three components as follows: (i) organ involvement or damage, (ii) the serum IgG4 concentration > 135 mg/dL, and (iii) IgG4+/ IgG+ cell ratio > 40% along with infiltration of > 10 IgG4+ cells/high power field (HPF) [2]. Although the exact causes of IgG4-RD ar
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