TY - JOUR
T1 - Diagnostic value of IgG4 Indices in IgG4-Related Hypertrophic Pachymeningitis
AU - Della-Torre, Emanuel
AU - Galli, Laura
AU - Franciotta, Diego
AU - Bozzolo, Enrica Paola
AU - Briani, Chiara
AU - Furlan, Roberto
AU - Roveri, Luisa
AU - Sessa, Maria
AU - Passerini, Gabriella
AU - Sabbadini, Maria Grazia
PY - 2014/1/15
Y1 - 2014/1/15
N2 - 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 IgG4Loc were significantly higher than in both controls and OHP. CSF IgG4 levels higher than 2.27mg/dL identified 100% of IgG4-HP and 5% of OHP. An IgG4Loc 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.
AB - 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 IgG4Loc were significantly higher than in both controls and OHP. CSF IgG4 levels higher than 2.27mg/dL identified 100% of IgG4-HP and 5% of OHP. An IgG4Loc 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.
KW - Cerebrospinal fluid
KW - Hypertrophic pachymeningitis
KW - IgG4
KW - IgG4-related disease
KW - IgG4-related pachymeningitis
KW - Pachymeningitis
UR - http://www.scopus.com/inward/record.url?scp=84891492023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84891492023&partnerID=8YFLogxK
U2 - 10.1016/j.jneuroim.2013.10.008
DO - 10.1016/j.jneuroim.2013.10.008
M3 - Article
AN - SCOPUS:84891492023
VL - 266
SP - 82
EP - 86
JO - Journal of Neuroimmunology
JF - Journal of Neuroimmunology
SN - 0165-5728
IS - 1-2
ER -