巴塞杜氏病 IgG4 血清浓度的临床意义

IF 2.9 4区 医学 Q3 IMMUNOLOGY Archivum Immunologiae et Therapiae Experimentalis Pub Date : 2024-07-20 eCollection Date: 2024-01-01 DOI:10.2478/aite-2024-0015
Michal Olejarz, Ewelina Szczepanek-Parulska, Aleksandra Krygier, Elzbieta Wrotkowska, Nadia Sawicka-Gutaj, Marek Ruchala
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引用次数: 0

摘要

免疫球蛋白 G4(IgG4)血清抗体升高是 IgG4 相关疾病的一个重要特征。然而,IgG4抗体也可能在自身免疫性甲状腺疾病中发挥作用。在这项研究中,我们旨在评估血清 IgG4 水平对巴塞杜氏病(GD)临床特征的影响。我们招募了 60 名 GD 患者(48 名无甲状腺眼病患者、12 名中重度巴塞杜氏眶病 [GO] 患者和 25 名健康对照组受试者)。在未患有巴塞杜氏眼病的 GD 患者中,IgG4 血清高浓度的发生率为 4.2%,而在中重度巴塞杜氏眼病患者中,IgG4 血清高浓度的发生率为 33.33%。GO组的IgG4水平中位数(87.9 mg/dL)明显高于对照组(41.2 mg/dL,P = 0.034)和无GO的GD组(30.75 mg/dL,P < 0.001)。甲状腺结节患者的 IgG4 水平低于无甲状腺结节患者,但差异无统计学意义(35.7 [24.8; 41.53] mg/dL vs. 43 [30.1; 92.7] mg/dL,P = 0.064)。作为中度至重度 GO 的诊断工具,IgG4 的参数如下:曲线下面积(AUC)为 0.851(P < 0.05):0.851 (P < 0.001),临界值为 49 mg/dL;阴性预测值:100%;阳性预测值:48%;灵敏度:100%;特异性:100%:灵敏度:100%,特异性:73%。高 IgG4 组和正常 IgG4 组在甲状腺激素、抗甲状腺抗体和超声特征方面无明显差异。血清 IgG4 水平与 GD 的某些临床特征相关,有助于疾病的诊断过程。要更好地了解 IgG4 参与 GD 的病理生理学,还需要进行更多的研究。
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Clinical Significance of IgG4 Serum Concentration in Graves' Disease.

Elevated immunoglobulin G4 (IgG4) serum antibodies are an important feature of IgG4-related disease. However, IgG4 antibodies can play a role in autoimmune thyroid disorders. In this study, we aimed to evaluate the impact of serum IgG4 levels on clinical features of Graves' disease (GD). We recruited 60 patients with GD (48 patients without thyroid eye disease, 12 patients with moderate-to-severe Graves' orbitopathy [GO], and 25 healthy control subjects). The prevalence of high IgG4 serum concentration was 4.2% among GD patients without GO and 33.33% in patients with moderate-to-severe GO. The group with GO had significantly higher median IgG4 levels (87.9 mg/dL) than the control group (41.2 mg/dL, P = 0.034) and the GD without GO group (30.75 mg/dL, P < 0.001). Patients with thyroid nodules had lower IgG4 levels than patients without thyroid nodules, but the difference was not statistically significant (35.7 [24.8; 41.53] mg/dL vs. 43 [30.1; 92.7] mg/dL, P = 0.064). IgG4 as a diagnostic tool for moderate-to-severe GO had the following parameters: area under the curve (AUC): 0.851 (P < 0.001), at the cut-off value of 49 mg/dL, negative predictive value: 100%, positive predictive value: 48%, sensitivity: 100%, specificity: 73%. There were no significant differences between the high and normal IgG4 groups in thyroid hormones, antithyroid antibodies, and ultrasound features. Serum IgG4 levels are associated with some of the clinical features of GD and can help in the diagnostic process of the disease. More research is needed to better understand the pathophysiology of IgG4 involvement in GD.

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来源期刊
CiteScore
5.90
自引率
0.00%
发文量
26
审稿时长
>12 weeks
期刊介绍: Archivum Immunologiae et Therapiae Experimentalis (AITE), founded in 1953 by Ludwik Hirszfeld, is a bimonthly, multidisciplinary journal. It publishes reviews and full original papers dealing with immunology, experimental therapy, immunogenetics, transplantation, microbiology, immunochemistry and ethics in science.
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