Clinical and pathological predictors of relapse in IgG4-related disease
Abstract Objectives In IgG4-related disease, the relationship between pathological findings and relapse has not been well established. This study aimed to identify the clinical and pathological predictors of disease relapse in IgG4-RD. Methods Patients with newly diagnosed IgG4-RD (n = 71) were enro...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-05-01
|
| Series: | Arthritis Research & Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13075-022-02792-z |
| _version_ | 1811252185568116736 |
|---|---|
| author | Ji Zongfei Chen Lingli Sun Ying Ma Lingying Zhang Lijuan Liu Dongmei Dai Xiaomin Hou Yingyong Chen Huiyong Ma Lili Jiang Lindi |
| author_facet | Ji Zongfei Chen Lingli Sun Ying Ma Lingying Zhang Lijuan Liu Dongmei Dai Xiaomin Hou Yingyong Chen Huiyong Ma Lili Jiang Lindi |
| author_sort | Ji Zongfei |
| collection | DOAJ |
| description | Abstract Objectives In IgG4-related disease, the relationship between pathological findings and relapse has not been well established. This study aimed to identify the clinical and pathological predictors of disease relapse in IgG4-RD. Methods Patients with newly diagnosed IgG4-RD (n = 71) were enrolled between January 2011 and April 2020; all cases were pathologically confirmed. The clinical and pathological features were recorded in a database at baseline and each follow-up visit. Patients were followed up at least once a month via outpatient clinic examinations and telephone calls. Univariate and multivariate Cox regression analyses and receiver operating curve (ROC) analysis were used to identify the predictors of disease relapse and to assess their predictive value. Results Over a median follow-up of 26 (range, 6–123) months, 3/71 (4.2%) patients died. Of the remaining 68 patients, 47 (69.1%) patients had achieved clinical remission and 21 (30.9%) had suffered relapse at the last follow-up. The independent predictors of relapse were IgG4 ≥ 6.5 g/L (HR = 2.84, 95% CI: 1.11–7.23), IgG ≥ 20.8 g/L (HR = 4.11, 95% CI: 1.53–11.06), IgG4-RD responder index (RI) ≥ 9 (HR = 3.82, 95% CI: 1.28–11.37), and severe IgG4+ plasma cell infiltration (HR = 6.32, 95% CI: 1.79–22.41). A prognostic score developed using three of the identified predictors (IgG ≥ 20.8 g/L, IgG4-RD RI ≥ 9, and severe IgG4+ plasma cell infiltration) showed good value for predicting impending relapse (AUC, 0.806). Conclusions In patients with IgG4-RD, IgG4 ≥ 6.5 g/L, IgG ≥ 20.8 g/L, IgG4-RD responder index (RI) ≥ 9, and severe IgG4+ plasma cell infiltration are predictors of relapse. |
| first_indexed | 2024-04-12T16:31:04Z |
| format | Article |
| id | doaj.art-70918b9f9cb0449b88414cce6761489b |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-04-12T16:31:04Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj.art-70918b9f9cb0449b88414cce6761489b2022-12-22T03:25:09ZengBMCArthritis Research & Therapy1478-63622022-05-012411810.1186/s13075-022-02792-zClinical and pathological predictors of relapse in IgG4-related diseaseJi Zongfei0Chen Lingli1Sun Ying2Ma Lingying3Zhang Lijuan4Liu Dongmei5Dai Xiaomin6Hou Yingyong7Chen Huiyong8Ma Lili9Jiang Lindi10Department of Rheumatology, Zhongshan Hospital, Fudan UniversityDepartment of Pathology, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Xiamen Branch, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Zhongshan Hospital, Fudan UniversityDepartment of Pathology, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Zhongshan Hospital, Fudan UniversityDepartment of Rheumatology, Zhongshan Hospital, Fudan UniversityAbstract Objectives In IgG4-related disease, the relationship between pathological findings and relapse has not been well established. This study aimed to identify the clinical and pathological predictors of disease relapse in IgG4-RD. Methods Patients with newly diagnosed IgG4-RD (n = 71) were enrolled between January 2011 and April 2020; all cases were pathologically confirmed. The clinical and pathological features were recorded in a database at baseline and each follow-up visit. Patients were followed up at least once a month via outpatient clinic examinations and telephone calls. Univariate and multivariate Cox regression analyses and receiver operating curve (ROC) analysis were used to identify the predictors of disease relapse and to assess their predictive value. Results Over a median follow-up of 26 (range, 6–123) months, 3/71 (4.2%) patients died. Of the remaining 68 patients, 47 (69.1%) patients had achieved clinical remission and 21 (30.9%) had suffered relapse at the last follow-up. The independent predictors of relapse were IgG4 ≥ 6.5 g/L (HR = 2.84, 95% CI: 1.11–7.23), IgG ≥ 20.8 g/L (HR = 4.11, 95% CI: 1.53–11.06), IgG4-RD responder index (RI) ≥ 9 (HR = 3.82, 95% CI: 1.28–11.37), and severe IgG4+ plasma cell infiltration (HR = 6.32, 95% CI: 1.79–22.41). A prognostic score developed using three of the identified predictors (IgG ≥ 20.8 g/L, IgG4-RD RI ≥ 9, and severe IgG4+ plasma cell infiltration) showed good value for predicting impending relapse (AUC, 0.806). Conclusions In patients with IgG4-RD, IgG4 ≥ 6.5 g/L, IgG ≥ 20.8 g/L, IgG4-RD responder index (RI) ≥ 9, and severe IgG4+ plasma cell infiltration are predictors of relapse.https://doi.org/10.1186/s13075-022-02792-zIgG4-related diseaseRelapsePrognostic factor |
| spellingShingle | Ji Zongfei Chen Lingli Sun Ying Ma Lingying Zhang Lijuan Liu Dongmei Dai Xiaomin Hou Yingyong Chen Huiyong Ma Lili Jiang Lindi Clinical and pathological predictors of relapse in IgG4-related disease Arthritis Research & Therapy IgG4-related disease Relapse Prognostic factor |
| title | Clinical and pathological predictors of relapse in IgG4-related disease |
| title_full | Clinical and pathological predictors of relapse in IgG4-related disease |
| title_fullStr | Clinical and pathological predictors of relapse in IgG4-related disease |
| title_full_unstemmed | Clinical and pathological predictors of relapse in IgG4-related disease |
| title_short | Clinical and pathological predictors of relapse in IgG4-related disease |
| title_sort | clinical and pathological predictors of relapse in igg4 related disease |
| topic | IgG4-related disease Relapse Prognostic factor |
| url | https://doi.org/10.1186/s13075-022-02792-z |
| work_keys_str_mv | AT jizongfei clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT chenlingli clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT sunying clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT malingying clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT zhanglijuan clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT liudongmei clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT daixiaomin clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT houyingyong clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT chenhuiyong clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT malili clinicalandpathologicalpredictorsofrelapseinigg4relateddisease AT jianglindi clinicalandpathologicalpredictorsofrelapseinigg4relateddisease |