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Abstract
Objective
This study aimed to evaluate the relationship between serum immunoglobulin G4 (IgG4) levels and the presence and disease activity of rheumatoid arthritis (RA).
Methods
The study enrolled 128 participants (RA, 96; healthy controls, 17; osteoarthritis, 11; and IgG4-related disease, 4) between March 2014 and July 2017. Blood samples were collected prior to the commencement of treatment, and serum IgG4 levels were determined using a nephelometric assay (levels ≥135 mg/dL were considered elevated). The levels of serum IgG4 and the ratio of IgG4/total IgG in patients with RA were compared with those in healthy controls, patients with osteoarthritis, and patients with IgG4-related disease. Furthermore, the relationship between serum IgG4 levels and RA disease activity was evaluated.
Results
Among the 96 patients with RA, the mean (±standard deviation) serum IgG4 level was 48.0±45.4 mg/dL; 6 (6.3%) patients had elevated serum IgG4 levels. However, none of the healthy controls or patients with osteoarthritis had elevated serum IgG4 levels. The mean serum IgG4/IgG ratio in patients with RA was 3.5%±2.8% (range, 0.2%∼16.9%). Using Spearman's correlation coefficient analysis, a significant correlation was found between serum IgG4 levels and the Disease Activity Score-28 with erythrocyte sedimentation rate (r, 0.245; p=0.016).
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Table 1.
Study participant characteristics
Table 2.
Correlation coefficients between the components of the rheumatoid arthritis disease activity index and serum IgG (total) and IgG4 levels and the IgG4/IgG ratio
| Variable | 28TJC | 28SJC | PtGA | ESR | CRP | DAS28-ESR | DAS28-CRP |
|---|---|---|---|---|---|---|---|
| Age | 0.146 | 0.126 | 0.089 | 0.195 | 0.188 | 0.154 | 0.159 |
| Diseaseduration | −0.213* | −0.208* | −0.235* | −0.116 | −0.052 | −0.202* | −0.238* |
| Serum IgG | 0.19 | 0.179 | 0.343** | 0.33** | 0.145 | 0.35** | 0.294** |
| Serum IgG4 | 0.15 | 0.151 | 0.174 | 0.262* | 0.109 | 0.245* | 0.193 |
| IgG4/IgG ratio | 0.101 | 0.099 | 0.047 | 0.188 | 0.054 | 0.144 | 0.82 |
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