Diagnostic value of IgG4 Indices in IgG4-Related Hypertrophic Pachymeningitis

被引：55

作者：

Della-Torre, Emanuel ^{[1
,2
]}

Galli, Laura ^{[3
]}

Franciotta, Diego ^{[4
]}

Bozzolo, Enrica Paola ^{[2
]}

Briani, Chiara ^{[5
]}

Furlan, Roberto ^{[6
]}

Roveri, Luisa ^{[7
]}

Sessa, Maria ^{[7
]}

Passerini, Gabriella ^{[8
]}

Sabbadini, Maria Grazia ^{[1
,2
]}

机构：

[1] Univ Vita Salute San Raffaele, Sch Med, San Raffaele Sci Inst, I-20132 Milan, Italy

[2] Ist Sci San Raffaele, Unit Med & Clin Immunol, I-20132 Milan, Italy

[3] Ist Sci San Raffaele, Dept Infect Dis, I-20100 Milan, Italy

[4] Natl Neurol Inst C Mondino, Lab Neuroimmunol, Pavia, Italy

[5] Univ Padua, Dept Neurosci, I-35128 Padua, Italy

[6] Ist Sci San Raffaele, Div Neurosci, Inst Expt Neurol, Clin Neuroimmunol Unit, I-20132 Milan, Italy

[7] Ist Sci San Raffaele, Dept Neurol, I-20132 Milan, Italy

[8] Ist Sci San Raffaele, I-20132 Milan, Italy

来源：

JOURNAL OF NEUROIMMUNOLOGY | 2014年 / 266卷 / 1-2期

关键词：

IgG4; IgG4-related disease; IgG4-related pachymeningitis; Hypertrophic pachymeningitis; Pachymeningitis; Cerebrospinal fluid; CEREBROSPINAL-FLUID ANALYSIS; DISEASE; IGG4;

D O I：

10.1016/j.jneuroim.2013.10.008

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Diagnosis of IgG4-Related Hypertrophic Pachymeningitis (IgG4-HP) relies on meningeal biopsies, because cerebrospinal fluid (CSF) diagnostic biomarkers are lacking. Here, we determined whether IgG4 intrathecal production could distinguish IgG4-HP from other disorders presenting with HP (OHP). In patients with IgG4-HP, the median CSF IgG4 concentration, IgG4 Index and IgG4(Loc) were significantly higher than in both controls and OHP. CSF IgG4 levels higher than 2.27 mg/dL identified 100% of IgG4-HP and 5% of OHP. An IgG4(Loc) cut-off of 0.47 identified 100% of IgG4-HP and no cases of OHP. Our results support CSF IgG4 quantification and IgG4 Indices as alternatives to meningeal biopsy for the diagnosis of IgG4-HP when this procedure is contraindicated or uninformative. (C) 2013 Elsevier B.V. All rights reserved.

引用

页码：82 / 86

页数：5

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