Application of detection in diagnosis and treatment and prognosis of IgG4-RD based on the level of serum IgG4

Objective To investigate the value of serum IgG4 detection in diagnosis, treatment, evaluation and outcome of IGG4-associated diseases (IgG4-RD).Methods The clinical data of 26 patients diagnosed with IgG4-RD in Huaian First Hospital Affiliated to Nanjing Medical University from March 2013 to October 2023 were retrospectively analyzed.Results The median age of onset was 65 (31-90) years, and the male to female ratio was 3.33:1. The first three symptoms were abdominal discomfort, skin scleral yellow stain and fever. Patients mainly involved multiple organs, the most commonly involved organs are lung, pancreas, liver, kidney, bile duct. Compared with the control group, NLR, PLR, ESR, CRP, TBIL, DBIL, ALT, AST, GGT, IgG, IgA and IgM were all abnormally elevated in the first hematological, biochemical and immune tests of the patients, with statistical significance, while C3 and C4 were all decreased, but there was no statistical difference. The first IgG4 level of IgG4-RD patients was correlated with the length of hospitalization, the length of return visit, and the dynamic changes of IgG4 level after return visit.Conclusion Serum IgG4 detection plays an important role in the diagnosis and treatment of IgG4-RD. In patients with abnormally high levels of IgG4, who are sensitive to high-dose glucocorticoid have a rapidly decline of IgG4 levels and a longer duration of symptom remission.