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Diagnostic value of IgG4 Indices in IgG4-Related Hypertrophic Pachymeningitis ☆ ☆☆ ★

Published on Jan 1, 2014in Journal of Neuroimmunology 2.65
· DOI :10.1016/j.jneuroim.2013.10.008
Emanuel Della-Torre13
Estimated H-index: 13
 (UniSR: Vita-Salute San Raffaele University), Laura Galli1
Estimated H-index: 1
 + 7 AuthorsMaria Grazia Sabbadini35
Estimated H-index: 35
 (UniSR: Vita-Salute San Raffaele University)
Abstract
Abstract 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.
  • References (15)
  • Citations (28)
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References15
Newest
Published on Nov 1, 2013in The Journal of Rheumatology 3.47
Emanuel Della-Torre13
Estimated H-index: 13
 (UniSR: Vita-Salute San Raffaele University), Gabriella Passerini8
Estimated H-index: 8
 (UniSR: Vita-Salute San Raffaele University)+ 7 AuthorsDiego Franciotta39
Estimated H-index: 39
To the Editor: Immunoglobulin G4-related disease (IgG4-RD) is characterized by fibrous swelling of affected organs, elevations in serum IgG4 concentrations, and responsiveness to glucocorticoid treatment1. Affected tissues display similar histological features: diffuse lymphoplasmacytic infiltration by numerous IgG4-positive plasma cells, occasional eosinophils, storiform fibrosis, and obliterative phlebitis2. IgG4-related hypertrophic pachymeningitis (IgG4-HP) has been identified as a character...
24 Citations Source Cite
Published on Jul 1, 2013in Medicine 2.03
Zachary S. Wallace17
Estimated H-index: 17
 , Mollie N. Carruthers15
Estimated H-index: 15
 + 5 AuthorsJohn H. Stone67
Estimated H-index: 67
Hypertrophic pachymeningitis (HP) is an inflammatory condition in which the dura mater of the cranium or spine becomes thickened, leading to symptoms that result from mass effect, nerve compression, or vascular compromise. The differential diagnosis of HP includes immune-mediated conditions such as rheumatoid arthritis and vasculitis, malignancies, and infections. Many times, no diagnosis is reached; in such cases, the disease has been described as idiopathic HP. IgG4-related disease (IgG4-RD) i...
82 Citations Source Cite
Published on Jun 1, 2013in Hepatology 14.08
Lucas Maillette de Buy Wenniger14
Estimated H-index: 14
 , Marieke E. Doorenspleet12
Estimated H-index: 12
 (UvA: University of Amsterdam)+ 6 AuthorsUlrich Beuers55
Estimated H-index: 55
Immunoglobulin G4 (IgG4)-associated cholangitis (IAC) is a manifestation of the recently discovered idiopathic IgG4-related disease. The majority of patients have elevated serum IgG4 levels and/or IgG4-positive B-cell and plasma cell infiltrates in the affected tissue. We hypothesized that clonally expanded, class-switched IgG4-positive B cells and plasma cells could be causal to these poorly understood phenomena. In a prospective cohort of six consecutive IAC patients, six healthy controls, and...
83 Citations Source Cite
Published on Sep 27, 2012in Pathology Research International
Fereydoun Davatchi29
Estimated H-index: 29
 (Tehran University of Medical Sciences)
Historical Background. The ISG criteria for Behcet's, created in 1990, have excellent specificity, but lack sensitivity. The International Criteria for Behcet's Disease (ICBD) was created in 2006, as replacement to ISG. The aim of this study was to compare their performance. ISG and ICBD Criteria. For ISG oral aphthosis is mandatory. The presence of any two of the following (genital aphthosis, skin lesions, eye lesions, and positive pathergy test) will diagnose/classify the patient as BD. For IC...
55 Citations Source Cite
Published on Sep 1, 2012in Modern Pathology 6.66
Vikram V. Deshpande85
Estimated H-index: 85
 (Harvard University), Yoh Zen62
Estimated H-index: 62
 (University of Cambridge)+ 38 AuthorsJudith A. Ferry57
Estimated H-index: 57
 (Harvard University)
IgG4-related disease is a newly recognized fibro-inflammatory condition characterized by several features: a tendency to form tumefactive lesions in multiple sites; a characteristic histopathological appearance; and-often but not always-elevated serum IgG4 concentrations. An international symposium on IgG4-related disease was held in Boston, MA, on 4-7 October 2011. The organizing committee comprising 35 IgG4-related disease experts from Japan, Korea, Hong Kong, the United Kingdom, Germany, Ital...
1,048 Citations Source Cite
Published on Aug 1, 2012in American Journal of Hematology 5.30
Angela Dispenzieri96
Estimated H-index: 96
 (UR: University of Rochester)
Disease overview: POEMS syndrome is a paraneoplastic syndrome due to an underlying plasma cell neoplasm. The major criteria for the syndrome are polyradiculoneuropathy, clonal plasma cell disorder (PCD), sclerotic bone lesions, elevated vascular endothelial growth factor, and the presence of Castleman disease. Minor features include organomegaly, endocrinopathy, characteristic skin changes, papilledema, extravascular volume overload, and thrombocytosis. Diagnoses are often delayed because the sy...
80 Citations Source Cite
Published on Mar 6, 2012in Annals of Internal Medicine 19.38
Emanuel Della Torre3
Estimated H-index: 3
 (UniSR: Vita-Salute San Raffaele University), E. Bozzolo17
Estimated H-index: 17
 (UniSR: Vita-Salute San Raffaele University)+ 2 AuthorsMaria Grazia Sabbadini35
Estimated H-index: 35
 (UniSR: Vita-Salute San Raffaele University)
29 Citations Source Cite
Published on Jan 1, 2011in Current Opinion in Rheumatology 4.28
Yoh Zen62
Estimated H-index: 62
 , Yasuni Nakanuma76
Estimated H-index: 76
Purpose of review To review studies that have examined underlying genetic and immunological aspects of IgG4-related disease. Recent findings Genetic studies have suggested that several human leukocyte antigen (HLA) and non-HLA haplotypes/genotypes are associated with susceptibility to IgG4-related disease or to disease relapse after steroid therapy. Among several autoantibodies identified so far, autoantibodies against lactoferrin and carbonic anhydrase II are most frequently detected in serum o...
103 Citations Source Cite
Published on Sep 1, 2010in Advances in Anatomic Pathology 2.36
Wah Cheuk30
Estimated H-index: 30
 , John K. C. Chan79
Estimated H-index: 79
An elevated serum titer of immunoglobulin G4 (IgG4), the least common (3% to 6%) of the 4 subclasses of IgG, is a surrogate marker for the recently characterized IgG4-related sclerosing disease. The syndrome affects predominantly middle-aged and elderly patients, with male predominance. The patients
287 Citations Source Cite
Published on Aug 11, 2006in Annals of the Rheumatic Diseases 12.35
Richard A. Watts49
Estimated H-index: 49
 (UEA: University of East Anglia), Se Lane14
Estimated H-index: 14
 + 7 AuthorsDavid G. I. Scott30
Estimated H-index: 30
 (Norwich University)
Background: The classification of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and polyarteritis nodosa (PAN) for epidemiology studies is confusing. The existing schemes such as American College of Rheumatology (ACR) criteria, Chapel Hill Consensus Conference (CHCC) definitions and Lanham criteria produce overlapping and conflicting classifications, making it difficult to compare incidence figures. Aim: To develop a consensus method of using these criteria and definitions for ...
569 Citations Source Cite
Cited By28
Newest
Published on Jul 1, 2019in Neuroimmunology and Neuroinflammation
M. Levraut , Mikael Cohen9
Estimated H-index: 9
 + 8 AuthorsNihal Martis3
Estimated H-index: 3
Objective Meningeal involvement in Immunoglobulin G (IgG)-4-related disease is rare and only described in case reports and series. Because a review into the disease is lacking, we present 2 cases followed by a literature review of IgG4-related hypertrophic pachymeningitis (IgG4-HP). Methods Two IgG4-HP cases were reported, one involving the spinal cord and responding to surgical management and a second involving the brain and responding to Rituximab therapy. We then review clinical cases and cas...
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Published on May 9, 2019in Childs Nervous System 1.24
Aruna Nambirajan4
Estimated H-index: 4
 , M. Chand Sharma + 3 AuthorsVivek Suri1
Estimated H-index: 1
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Published on Mar 4, 2019in Expert Review of Clinical Immunology 3.44
Kazunori Yamada15
Estimated H-index: 15
 (Kanazawa University), Ichiro Mizushima11
Estimated H-index: 11
 (Kanazawa University), Mitsuhiro Kawano29
Estimated H-index: 29
 (Kanazawa University)
ABSTRACTIntroduction: Recently, IgG4-related disease (IgG4-RD) has become a well-recognized clinical entity, although its causes are still not well understood. The pathophysiology of IgG4-RD has been reported from a variety of aspects.Areas covered: In this review, we outline a number of recent advances in our understanding of the pathogenesis of IgG4-RD, divided according to acquired immunology and innate immunology and other topics. Furthermore, we also focus on some proposed markers of diseas...
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Published on Jul 1, 2018in Neuroradiology 2.35
Jasmina Boban2
Estimated H-index: 2
 (University of Novi Sad), Selin Ardalı2
Estimated H-index: 2
 (Hacettepe University), Majda M. Thurnher27
Estimated H-index: 27
 (Medical University of Vienna)
Purpose Immunoglobulin G4 (IgG4)-related disease represents a spectrum of fibro-inflammatory disorders that affects various organ systems, including the central nervous system.
1 Citations Source Cite
Published on Jun 1, 2018in Apmis 2.03
Jacob R. Bledsoe5
Estimated H-index: 5
 (UMMS: University of Massachusetts Medical School), Emanuel Della-Torre13
Estimated H-index: 13
 (UniSR: Vita-Salute San Raffaele University)+ 1 AuthorsVikram V. Deshpande85
Estimated H-index: 85
 (Harvard University)
4 Citations Source Cite
Published on May 8, 2018in Neurology 8.05
Luuk Wieske1
Estimated H-index: 1
 , Ulrich Beuers , Margreet Brouwer43
Estimated H-index: 43
A 65-year-old man working as a car dealer was referred to our neurology outpatient clinic because of a pituitary mass. Two years before referral, the patient had developed symptoms of polyuria and polydipsia, decreased endurance while working out, fatigue, loss of body hair, and erectile dysfunction. The endocrinologist found hypogonadotropic hypogonadism, hypocortisolism, and central diabetes insipidus, which was treated with testosterone, hydrocortisone, and desmopressin, resulting in adequate...
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Published on Apr 1, 2018in Cephalalgia 3.89
Antonio Russo66
Estimated H-index: 66
 , Marcello Silvestro3
Estimated H-index: 3
 + 2 AuthorsGioacchino Tedeschi34
Estimated H-index: 34
2 Citations Source Cite
Published on Feb 1, 2018in Lancet Neurology 27.14
Mahmoud A. AbdelRazek1
Estimated H-index: 1
 (Harvard University), Nagagopal Venna16
Estimated H-index: 16
 (Harvard University), John H. Stone67
Estimated H-index: 67
 (Harvard University)
Summary IgG4-related disease can involve nearly any organ system, including the central and peripheral nervous systems. The pathology findings are consistent from organ to organ, but careful clinicopathological correlation is necessary to establish the diagnosis. Many non-neurological and neurological inflammatory conditions, previously regarded as idiopathic in nature, are now recognised to fall within the spectrum of IgG4-related disease. The condition is highly treatable, but probably remains...
5 Citations Source Cite
Published on Nov 1, 2017in Rheumatic Diseases Clinics of North America 3.52
Mahmoud A. AbdelRazek1
Estimated H-index: 1
 (Mayo Clinic), John H. Stone67
Estimated H-index: 67
 (Harvard University)
1 Citations Source Cite
Published on Nov 1, 2017in International Journal of Rheumatic Diseases 2.42
Andreu Fernández Codina7
Estimated H-index: 7
 (Autonomous University of Barcelona), Manuel Hernández-González3
Estimated H-index: 3
 (Autonomous University of Barcelona)+ 3 AuthorsFernando Martínez-Valle7
Estimated H-index: 7
 (Autonomous University of Barcelona)
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