Hypocomplementemia is related to elevated serum levels of IgG subclasses other than IgG4 in IgG4-related kidney disease

被引：15

作者：

Fujisawa, Yuhei ^{[1
,2
]}

Mizushima, Ichiro ^{[2
]}

Yamada, Kazunori ^{[2
,3
]}

Yamamoto, Motohisa ^{[4
]}

Saeki, Takako ^{[5
]}

Matsui, Shoko ^{[6
]}

Tsuge, Syunsuke ^{[2
]}

Hara, Satoshi ^{[2
]}

Ito, Kiyoaki ^{[2
]}

Fujii, Hiroshi ^{[2
]}

Takahashi, Hiroki ^{[4
]}

Nomura, Hideki ^{[7
]}

Kawa, Shigeyuki ^{[8
]}

Kawano, Mitsuhiro ^{[2
]}

机构：

[1] Kanazawa Univ, Graduates Sch Med, Dept Cardiovasc & Internal Med, Div Rheumatol, Kanazawa, Ishikawa, Japan

[2] Kanazawa Univ Hosp, Dept Internal Med, Div Rheumatol, Takaramachi 13-1, Kanazawa, Ishikawa, Japan

[3] Kanazawa Univ, Grad Sch Med Sci, Dept Adv Res Community Med, Kanazawa, Ishikawa, Japan

[4] Sapporo Med Univ, Sch Med, Dept Rheumatol & Clin Immunol, Sapporo, Hokkaido, Japan

[5] Nagaoka Red Cross Hosp, Dept Internal Med, Niigata, Japan

[6] Univ Toyama, Hlth Adm Ctr, Toyama, Japan

[7] Kanazawa Univ Hosp, Dept Gen Med, Kanazawa, Ishikawa, Japan

[8] Matsumoto Dent Univ, Dept Internal Med, Shiojiri, Japan

来源：

MODERN RHEUMATOLOGY | 2021年 / 31卷 / 01期

关键词：

Hypocomplementemia; IgG4-related kidney disease; IgG subclass; LUNG-DISEASE; COMPLEMENT; ACTIVATION; MECHANISMS;

D O I：

10.1080/14397595.2019.1709942

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: This study investigated the clinical features of IgG4-RKD patients with hypocomplementemia compared with those without it, so as to clarify the factors related to hypocomplementemia. Methods: In this single-center retrospective study, we analyzed the clinical features of 25 patients with IgG4-RKD according to the presence/absence of hypocomplementemia. Additionally, we validated the results of a single-center study in a separate large multicenter cohort of 328 patients with IgG4-RD, and searched for factors related to hypocomplementemia. Results: Serum IgG levels (p < .001), non-IgG4 IgG levels, calculated as the total IgG minus IgG4 (p < .001), serum IgG1 levels (p = .017), and the number of involved organs (p = .018) were significantly higher in the hypocomplementemia group. At relapse of renal lesions in four patients, all had serum IgG4 re-elevation, with the three with hypocomplementemia presenting worsening of hypocomplementemia and re-elevation of non-IgG4 IgG levels. In a validation cohort of 328 patients with IgG4-RD, multivariate logistic regression analysis indicated elevation of non-IgG4 IgG levels to be an independent factor related to hypocomplementemia in the patients with IgG4-RKD. Conclusion: The present study suggests that hypocomplementemia is associated with elevation of IgG subclasses other than IgG4 including IgG1 in IgG4-RKD.

引用

页码：241 / 248

页数：8

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