Tissue IgG2/IgG4 Ratio as an Additional Tool to Distinguish IgG4-Related Disease From Other Fibroinflammatory Disorders

被引：2
作者：
Detiger, Sanne E. [1 ]
Paridaens, Dion [2 ,3 ]
van Hagen, Martin [4 ,5 ]
Karim, Faiz [7 ]
van Laar, Jan A. M. [4 ,5 ]
Verdijk, Robert M. [6 ]
机构：
[1] Rotterdam Eye Hosp, Rotterdam, Netherlands
[2] Rotterdam Eye Hosp, Dept Oculoplast Orbital & Lacrimal Surg, Rotterdam, Netherlands
[3] Erasmus MC, Univ Med Ctr Rotterdam, Dept Ophthalmol, Rotterdam, Netherlands
[4] Erasmus MC, Univ Med Ctr Rotterdam, Dept Internal Med, Sect Clin Immunol, Rotterdam, Netherlands
[5] Erasmus MC, Univ Med Ctr Rotterdam, Dept Immunol, Sect Clin Immunol, Rotterdam, Netherlands
[6] Erasmus MC, Univ Med Ctr Rotterdam, Dept Pathol, Sect Ophthalm Pathol, NL-3015 GD Rotterdam, Netherlands
[7] Groene Hart Hosp, Dept Internal Med, Gouda, Netherlands
来源：
APPLIED IMMUNOHISTOCHEMISTRY & MOLECULAR MORPHOLOGY | 2022年 / 30卷 / 07期
关键词：
IgG4-related disease; IgG; IgG2; IgG4; ratio; IMMUNOGLOBULIN G4-RELATED DISEASE; STATEMENT; CELLS;
D O I：
10.1097/PAI.0000000000001040
中图分类号：
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号：
100101 ;
摘要：
Interpretation of biopsies taken on suspicion of immunoglobulin (Ig)G4-related disease (IgG4-RD) may be hampered by uninterpretable immunohistochemical stains for IgG because of strong background signals. This study aims to determine the significance of tissue IgG2 positive plasma cell counts in IgG4-RD in comparison with non-IgG4-related inflammatory disorders. Descriptive, retrospective case-control study of 16 patients with IgG4-related orbital disease (IgG4-ROD) and 24 with extraorbital IgG4-RD. Histopathology and serology of this group was compared with 16 patients with orbital non-IgG4-related disorders and 22 patients with extraorbital non-IgG4-related disorders. The mean tissue IgG2/IgG4 ratio was 0.16 in IgG4-ROD and 0.27 in extraorbital IgG4-RD and far below 1 in 98% of patients. This was significantly lower compared with the non-IgG4-related disorders that showed a mean tissue IgG2/IgG4 ratio of 1.98 in the orbital and 2.20 in the extraorbital group (range: 0.20 to 10, P<0.05). In 74% of tissue samples an IgG2/IgG4 ratio >1 was seen. The tissue IgG2/IgG ratio was significantly lower in IgG4-RD compared with non-IgG4-related inflammatory disorders. Serum IgG2 concentration was not abnormal in patients with IgG4-RD. A significantly lower tissue IgG2/IgG4 and IgG2/IgG ratio was observed in IgG4-RD, compared with non-IgG4-related inflammatory disorders. Additional immunohistochemical staining for IgG2 positive plasma cells can be helpful in the diagnosis of IgG4-RD. Especially in cases with uninterpretable IgG staining, a well-recognized problem that may give rise to a failed interpretation of the biopsy.
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收藏
页码：517 / 525
页数：9
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