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Increases in IgE, Eosinophils, Mast Cells Can ID IgG4-RD

Last Updated: August 28, 2017.

Most patients with immunoglobulin G subclass 4-related disease have increased levels of immunoglobulin E, eosinophils, and mast cells, according to research published in the September issue of Clinical Gastroenterology and Hepatology.

MONDAY, Aug. 28, 2017 (HealthDay News) -- Most patients with immunoglobulin G subclass 4-related disease (IgG4-RD) have increased levels of IgE, eosinophils, and mast cells, according to research published in the September issue of Clinical Gastroenterology and Hepatology.

In a prospective study, Emma L. Culver, M.B.Ch.B., from John Radcliff Hospital in Oxford, U.K., and colleagues recruited 48 patients with IgG4-RD, 42 with an increased serum level of IgG4 with other inflammatory and autoimmune conditions (disease controls), and 51 healthy individuals.

The researchers found that in patients with IgG4-RD, serum levels of IgG4 increased to ≥1.4 g/L and IgE increased to ≥125 kIU/L in 81 and 54 percent, respectively, compared with 6 and 16 percent of healthy controls, respectively. Peripheral blood eosinophilia was seen in 38 and 9 percent of patients with IgG4-RD and healthy controls, respectively. IgE at diagnosis >480 kIU/L differentiated patients with IgG4-RD from disease controls with specificity and sensitivity of 86 and 36 percent, and with a likelihood ratio of 3.2. Patients with relapse were identified by IgE at diagnosis >380 kIU/L with specificity and sensitivity of 88 and 64 percent, and a likelihood ratio of 5.4. Among patients with IgG4-RD, 50 and 86 percent had IgE-positive mast cells and eosinophilia in lymphoid, biliary, and pancreatic tissue samples.

"An IgE-mediated allergic response therefore seems to develop in most patients with IgG4-RD; levels of IgE might be used in diagnosis and predicting relapse," the authors write.

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