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Heart and Vessels

, Volume 32, Issue 10, pp 1176–1185 | Cite as

Clinical features and predictive value of serum inflammatory markers of perivascular involvement in immunoglobulin G4-related disease

  • Hideya YamamotoEmail author
  • Eiji Sugiyama
  • Masahiro Serikawa
  • Fuminari Tatsugami
  • Michiya Yokozaki
  • Toshiro Kitagawa
  • Atsushi Senoo
  • Yumiko Kubo Nakamoto
  • Kazuo Awai
  • Kazuaki Chayama
  • Yasuki Kihara
Original Article

Abstract

Vascular and/or perivascular involvements of sclerotic inflammation (perivasculitis) are a complication of immunoglobulin G4-related disease (IgG4-RD). We sought to examine clinical manifestations of perivasculitis by computed tomography (CT) in patients with elevated serum IgG4 levels, and then to evaluate some potential predictors of perivasculitis in definite IgG4-RD patients. From a database of patients with serum IgG4 measurements, we selected 81 patients with elevated serum IgG4 levels (≥135 mg/dl). Perivasculitis was defined radiologically as thickened contrast-enhanced rind surrounding the aorta and its major artery on CT imaging. We found 15 patients with perivasculitis; 10 patients in the definite (n = 37), four in the possible (n = 18), and one in the excluded (n = 26) IgG4-RD groups. Clinical predictors of perivasculitis were investigated in 34 untreated patients with definite IgG4-RD. Patients with perivasculitis (n = 10) had significantly higher age at diagnosis (74.2 ± 8.8 vs 63.5 ± 9.9 years, P = 0.006), higher levels of serum IgG4 (754 vs 292 mg/dl, P = 0.007) and C-reactive protein (CRP, 0.52 mg/dl vs 0.10 mg/dl, P = 0.001) than patients without perivasculitis (n = 24). The sensitivity and specificity of serum CRP ≥0.25 mg/dl for identifying perivasculitis in the definite IgG4-RD group were 100 and 71%, respectively (area under the receiver operating characteristic curve 0.863). Our results indicate that IgG4-related perivasculitis was associated with elevated levels of serum CRP and older age, and that CRP may be a useful marker for detecting perivascular involvement in IgG4-RD.

Keywords

Immunoglobulin G4 Perivasculitis Computed tomography Aneurysm C-reactive protein 

Notes

Compliance with ethical standards

Funding

Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Tokyo, Japan, No. 26461111).

Conflict of interest

None of the authors has a conflict of interest to declare.

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Copyright information

© Springer Japan 2017

Authors and Affiliations

  • Hideya Yamamoto
    • 1
    Email author
  • Eiji Sugiyama
    • 2
  • Masahiro Serikawa
    • 3
  • Fuminari Tatsugami
    • 4
  • Michiya Yokozaki
    • 5
  • Toshiro Kitagawa
    • 1
  • Atsushi Senoo
    • 1
  • Yumiko Kubo Nakamoto
    • 1
  • Kazuo Awai
    • 4
  • Kazuaki Chayama
    • 3
  • Yasuki Kihara
    • 1
  1. 1.Department of Cardiovascular MedicineHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
  2. 2.Department of Clinical Immunology and RheumatologyHiroshima University HospitalHiroshimaJapan
  3. 3.Department of Gastroenterology and MetabolismHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
  4. 4.Department of Diagnostic RadiologyHiroshima University Graduate School of Biomedical and Health SciencesHiroshimaJapan
  5. 5.Clinical LaboratoryHiroshima University HospitalHiroshimaJapan

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