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Serum immunoglobulin G4 has limited diagnostic value in immunoglobulin G4-related chronic rhinosinusitis

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the profiles and factors influencing serum IgG4 levels and evaluate the diagnostic value of serum IgG4 in IgG4-related CRS.

Methods

This was a prospective study analyzing data from 288 hospitalized CRS patients who had undergone endoscopic sinus surgery from July 1, 2017 to August 31, 2018. Data were analyzed for correlations between elevated serum IgG4 concentrations (> 135 mg/dL) and clinical symptoms (nasal congestion, rhinorrhea, loss of smell, headache and/or facial pain), endoscopic presentation (Lund–Kennedy scores), allergic status (total and allergen-specific IgE), and pathological features (IgG4+ and IgG+ cells).

Results

Overall, 43/288 (14.9%) CRS patients had elevated serum IgG4 levels > 135 mg/dL. Comparison of the clinical parameters between patients with elevated and normal serum IgG4 levels demonstrated serum total IgE levels to be significantly different (P = 0.003) between the two groups; and significantly correlated with serum IgG4 level in CRS subjects (P = 0.000; r = 0.232), particularly CRS patients with nasal polyps (P = 0.000; r = 0.259). In contrast, the ratio of plasmocyte/inflammatory cells and IgG4+ cells/IgG+ plasmocytes, and IgG4+ plasma cells/HPF in sinus mucosa were not significantly different between the groups and no patient with elevated serum IgG4 demonstrated ratio of IgG4+ /IgG+ cells > 40% or > 10 IgG4+ plasma cells/HPF.

Conclusion

Serum IgG4 concentration is not related to the clinical phenotype of CRS and is likely to be of limited value when used alone in the diagnosis of IgG4-related CRS.

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Abbreviations

AIT:

Allergen-specific immunotherapy

BMI:

Body mass index

CDC:

Comprehensive diagnostic criteria

CRS (sNP/wNP):

Chronic rhinosinusitis (without/with nasal polyps)

DM:

Diabetes mellitus

GLU:

Blood glucose

HDL:

High-density lipoprotein

HDM:

House dust mite

HPF:

High power field

HT:

Hypertensive disease

Ig (E/G4):

Immunoglobulin (E/G4)

IgG4-RD:

Immunoglobulin G4-related disease

LDL:

Low-density lipoprotein

PBE:

Peripheral blood eosinophilia

SD:

Standard deviation

TC:

Total cholesterol

TG:

Triglycerides

Th 1/2/Reg:

Type 1/2 helper T cells

T-Regs:

Naive regulatory T cells

Tregs:

Regulatory T cells

VAS:

Visual analog scale

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Funding

This work was supported by grants from the national key R&D program of China (2016YFC0905200), the program for the Changjiang scholars and innovative research team (IRT13082), the national natural science foundation of China (81630023 and 82071022), Beijing municipal administration of hospitals’ mission plan (SML20150203), and Beijing talents foundation (2018000021223ZK14).

Author information

Author notes

  1. Lianqi Wan and Yingshi Piao contributed equally to this work.

Authors and Affiliations

  1. Department of Allergy, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100005, People’s Republic of China

    Lianqi Wan, Yuan Zhang & Luo Zhang

  2. Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100005, People’s Republic of China

    Chengshuo Wang, Yuan Zhang & Luo Zhang

  3. Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, No. 17, HouGouHuTong, DongCheng District, Beijing, 100005, People’s Republic of China

    Chengshuo Wang, Yuan Zhang & Luo Zhang

  4. Department of Pathology, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100005, People’s Republic of China

    Yingshi Piao

  5. Beijing Key Laboratory of Head and Neck Molecular Pathological Diagnosis, Beijing TongRen Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100005, People’s Republic of China

    Yingshi Piao

Authors
  1. Lianqi Wan
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  2. Yingshi Piao
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  3. Chengshuo Wang
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  4. Yuan Zhang
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Corresponding authors

Correspondence to Yuan Zhang or Luo Zhang.

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All authors declare no conflict of interest.

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This study was approved by the Ethics Committee of Beijing TongRen Hospital.

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Written informed consent was obtained from all patients before data collection.

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Wan, L., Piao, Y., Wang, C. et al. Serum immunoglobulin G4 has limited diagnostic value in immunoglobulin G4-related chronic rhinosinusitis. Eur Arch Otorhinolaryngol 279, 2951–2958 (2022). https://doi.org/10.1007/s00405-021-07083-y

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  • DOI: https://doi.org/10.1007/s00405-021-07083-y

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