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Diagnostic value of IgG4 Indices in IgG4-Related Hypertrophic Pachymeningitis

机译:IgG4指标在IgG4相关性肥厚性脑膜炎中的诊断价值

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摘要

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.
机译:IgG4相关性肥厚性脑膜炎(IgG4-HP)的诊断依赖于脑膜活检,因为缺乏脑脊液(CSF)诊断生物标志物。在这里,我们确定了IgG4鞘内产生是否可以将IgG4-HP与其他表现为HP(OHP)的疾病区分开。在患有IgG4-HP的患者中,CSF IgG4的中位数浓度,IgG4指数和IgG4Loc均显着高于对照组和OHP。高于2.27mg / dL的CSF IgG4水平可确定100%的IgG4-HP和5%的OHP。 IgG4Loc临界值为0.47,表示100%的IgG4-HP,没有OHP病例。我们的结果支持脑脊液IgG4定量和IgG4指标作为该方法禁忌或无意义的诊断IgG4-HP的脑膜活检的替代方法。

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