Journals on Neuro Imaging - BJSTR Journal

Abstract

#IgG4, a subclass of #immunoglobulin G (IgG), can associate various neurological pathologies in three patterns; (i) pathogenicity of specific autoantibodies in IgG4 subclass (e.g. anti-neurofascin IgG4 antibodies), (ii) neurological manifestation (e.g. hypertrophic pachymeningitis) of IgG4-related diseases (IgG4-RD) and (in) participation of IgG4 with other clinical entity (e.g. antineutrophil cytoplasmic antibody (ANCA)-associated #vasculitis) [1-5]. However, accurate prevalence and characteristics of neurological abnormality associated with IgG4 are not completely disclosed, especially in daily practice of clinical neurology. Thereby, we authors were motivated to examine serum IgG4 level as the simple and efficient way because it often elevates in IgG4 RD (especially>135 mg/dL as a commonly used cutoff) and other inflammatory/dysimmune disorders, i.e. pattern (ii) and (iii) above [3,6,7]. On the contrary, it was difficult to examine specific #autoantibodies in IgG4 subclass in pattern (i) above in our situation.This is a retrospective chart-review of clinical information with serum IgG4 level (reference value; 4.5-117 mg/dL) and total IgG (reference value; 870-1700mg/dL), measured by immunonephelometry (SRL Inc., Tokyo, Japan) in our institution. All the enrolled patients were Japanese origin.

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Clinical Significance and Prevalence of Serum IGG4 Elevation in General Neurology by Hiroyuki Todo in BJSTR