Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Scand J Rheumatol. 2019 Nov;48(6):497-504. doi: 10.1080/03009742.2019.1602882. Epub 2019 Jul 29.
: To elucidate the distribution characteristics of elevated serum immunoglobulin G (IgG) and its relationship with immunoglobulin G-related disease (IgG-RD).: In total, 14 522 unique patients who were tested for serum IgG over a 4.5 year period were enrolled. Demographic and serological characteristics of all patients, and the range of diseases and serological characteristics of patients with elevated serum IgG, were retrospectively analysed. Organ involvement in IgG-RD patients and the utility of serum immunoglobulin for distinguishing IgG-RD from non-IgG-RD were also investigated.: Elevated serum IgG (> 1.4 g/L) was observed in 1793/14 522 patients (12.3%) and primarily appeared in middle-aged and elderly men. Only 7.3% of patients with elevated serum IgG met the diagnostic criteria for IgG-RD. Elevated serum IgG was also found in over 30 types of non-IgG-RD. Serum IgG levels were higher in IgG-RD patients with multiple-organ involvement and were positively correlated with the number of affected organs. The diagnostic utility of serum IgG for IgG-RD was higher than that of the IgG/IgG ratio and serum IgG. The optimal serum IgG cut-off value for diagnosing IgG-RD was 2.06 g/L, with a sensitivity of 95.6% and specificity of 94.7%.: Elevated serum IgG may be present in multiple non-IgG-RD conditions. However, a high serum IgG concentration is of great value for IgG-RD diagnosis, and there appears to be a positive relationship between serum IgG levels and organ involvement in patients with IgG-RD. Examining the IgG/IgG ratio and serum IgG does not improve the ability of IgG-RD diagnosis.
阐明血清免疫球蛋白 G（IgG）升高的分布特征及其与 IgG 相关疾病（IgG-RD）的关系。
共纳入 14522 例在 4.5 年内检测血清 IgG 的患者。回顾性分析所有患者的人口统计学和血清学特征，以及血清 IgG 升高患者的疾病范围和血清学特征。还研究了 IgG-RD 患者的器官受累情况以及血清免疫球蛋白对区分 IgG-RD 与非 IgG-RD 的作用。
在 14522 例患者中，有 1793/14522 例（12.3%）患者血清 IgG 升高，主要为中老年人，男性居多。仅有 7.3%的血清 IgG 升高患者符合 IgG-RD 的诊断标准。在 30 多种非 IgG-RD 中也发现了升高的血清 IgG。多器官受累的 IgG-RD 患者血清 IgG 水平更高，且与受累器官的数量呈正相关。血清 IgG 对 IgG-RD 的诊断作用高于 IgG/IgG 比值和血清 IgG。诊断 IgG-RD 的最佳血清 IgG 截断值为 2.06g/L，其灵敏度为 95.6%，特异性为 94.7%。
升高的血清 IgG 可能存在于多种非 IgG-RD 情况下。然而，高血清 IgG 浓度对 IgG-RD 诊断具有重要价值，且 IgG-RD 患者的血清 IgG 水平与器官受累之间似乎呈正相关。检查 IgG/IgG 比值和血清 IgG 并不能提高 IgG-RD 诊断的能力。
