Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease.
<h4>Introduction</h4>We aimed to investigate the predictors of relapse in immunoglobulin G4-related disease (IgG4-RD), focusing on the serum IgG4 levels during initial treatment.<h4>Methods</h4>We retrospectively recruited 57 patients with IgG4-RD who were treated with immuno...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0282852 |
| _version_ | 1827963246554906624 |
|---|---|
| author | Su Jin Choi Soo Min Ahn Ji Seon Oh Seokchan Hong Chang-Keun Lee Bin Yoo Yong-Gil Kim |
| author_facet | Su Jin Choi Soo Min Ahn Ji Seon Oh Seokchan Hong Chang-Keun Lee Bin Yoo Yong-Gil Kim |
| author_sort | Su Jin Choi |
| collection | DOAJ |
| description | <h4>Introduction</h4>We aimed to investigate the predictors of relapse in immunoglobulin G4-related disease (IgG4-RD), focusing on the serum IgG4 levels during initial treatment.<h4>Methods</h4>We retrospectively recruited 57 patients with IgG4-RD who were treated with immunosuppressants and elevated serum IgG4 levels in a tertiary hospital between January 2011 and December 2020. They were followed up for ≥ 6 months after initiation of immunosuppressive therapy. Clinical and laboratory findings including serum IgG4 levels (reference value: 6-121 mg/dL) were compared between relapsed (n = 13) and non-relapsed (n = 44) groups. Multivariate Cox regression analysis was used to assess the predictors for relapse. We performed a Kaplan-Meier analysis with a log-rank test to evaluate the cumulative relapse rate for two years.<h4>Results</h4>Median serum IgG4 levels at baseline were 321 mg/dL in the relapsed group and 299 mg/dL in the non-relapsed group. Serum IgG4 levels were normalized after six months in five (38.5%) relapsed and 28 (63.6%) non-relapsed patients. In multivariate Cox regression analysis, the normalization of serum IgG4 levels at six months was associated with a lower risk of relapse, with a hazard ratio of 0.232 (p = 0.019). Central nervous system involvement was associated with the relapse, with a hazard ratio of 21.130 (p = 0.015). The cumulative relapse rate for two years was lower in the normal serum IgG4 group at six months than in the elevated serum IgG4 group at six months (p = 0.027).<h4>Conclusion</h4>Our study suggests that normalization of serum IgG4 levels during immunosuppressive treatment for IgG4-RD independently predicts relapse-free outcomes. Thus, monitoring serum IgG4 levels might be used as a marker of prognosis. |
| first_indexed | 2024-04-09T16:56:06Z |
| format | Article |
| id | doaj.art-98f81a4aa9f64dd39e3ccfd2a9cd6c70 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-09T16:56:06Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-98f81a4aa9f64dd39e3ccfd2a9cd6c702023-04-21T05:36:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183e028285210.1371/journal.pone.0282852Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease.Su Jin ChoiSoo Min AhnJi Seon OhSeokchan HongChang-Keun LeeBin YooYong-Gil Kim<h4>Introduction</h4>We aimed to investigate the predictors of relapse in immunoglobulin G4-related disease (IgG4-RD), focusing on the serum IgG4 levels during initial treatment.<h4>Methods</h4>We retrospectively recruited 57 patients with IgG4-RD who were treated with immunosuppressants and elevated serum IgG4 levels in a tertiary hospital between January 2011 and December 2020. They were followed up for ≥ 6 months after initiation of immunosuppressive therapy. Clinical and laboratory findings including serum IgG4 levels (reference value: 6-121 mg/dL) were compared between relapsed (n = 13) and non-relapsed (n = 44) groups. Multivariate Cox regression analysis was used to assess the predictors for relapse. We performed a Kaplan-Meier analysis with a log-rank test to evaluate the cumulative relapse rate for two years.<h4>Results</h4>Median serum IgG4 levels at baseline were 321 mg/dL in the relapsed group and 299 mg/dL in the non-relapsed group. Serum IgG4 levels were normalized after six months in five (38.5%) relapsed and 28 (63.6%) non-relapsed patients. In multivariate Cox regression analysis, the normalization of serum IgG4 levels at six months was associated with a lower risk of relapse, with a hazard ratio of 0.232 (p = 0.019). Central nervous system involvement was associated with the relapse, with a hazard ratio of 21.130 (p = 0.015). The cumulative relapse rate for two years was lower in the normal serum IgG4 group at six months than in the elevated serum IgG4 group at six months (p = 0.027).<h4>Conclusion</h4>Our study suggests that normalization of serum IgG4 levels during immunosuppressive treatment for IgG4-RD independently predicts relapse-free outcomes. Thus, monitoring serum IgG4 levels might be used as a marker of prognosis.https://doi.org/10.1371/journal.pone.0282852 |
| spellingShingle | Su Jin Choi Soo Min Ahn Ji Seon Oh Seokchan Hong Chang-Keun Lee Bin Yoo Yong-Gil Kim Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease. PLoS ONE |
| title | Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease. |
| title_full | Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease. |
| title_fullStr | Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease. |
| title_full_unstemmed | Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease. |
| title_short | Serum IgG4 level during initial treatment as a predictor of relapse in IgG4-related disease. |
| title_sort | serum igg4 level during initial treatment as a predictor of relapse in igg4 related disease |
| url | https://doi.org/10.1371/journal.pone.0282852 |
| work_keys_str_mv | AT sujinchoi serumigg4levelduringinitialtreatmentasapredictorofrelapseinigg4relateddisease AT soominahn serumigg4levelduringinitialtreatmentasapredictorofrelapseinigg4relateddisease AT jiseonoh serumigg4levelduringinitialtreatmentasapredictorofrelapseinigg4relateddisease AT seokchanhong serumigg4levelduringinitialtreatmentasapredictorofrelapseinigg4relateddisease AT changkeunlee serumigg4levelduringinitialtreatmentasapredictorofrelapseinigg4relateddisease AT binyoo serumigg4levelduringinitialtreatmentasapredictorofrelapseinigg4relateddisease AT yonggilkim serumigg4levelduringinitialtreatmentasapredictorofrelapseinigg4relateddisease |