Elevated Serum IgG4 Defines Specific Clinical Phenotype of XXXX .

@entity1 @entity6963 @entity2225 @entity603 @entity3053 @entity1499 @entity309 @entity1851
Objectives. To explore the correlation of serum IgG4 (sIgG4) with clinical manifestations or therapeutic response in @entity309 ( @entity309 ). Methods. Consecutive 136 @entity309 @entity1 were recruited and followed up at regular interval. SIgG4 was detected by immunonephelometry. Serial synovial tissue sections from 46 @entity309 @entity1 were stained immunohistochemically for IgG4. Results. Forty-six percent of 136 @entity309 @entity1 had elevated sIgG4. @entity1 with elevated sIgG4 had higher sIgG4/sIgG ratio, @entity1851 , erythrocyte sedimentation rate, rheumatoid factor, and anticyclic citrullinated peptide antibodies than those with normal sIgG4 (all P < 0.05). Among 45 @entity1 who received @entity1499 and @entity6963 therapy, 50% (9/18) of @entity1 with elevated sIgG4 and 85% (23/27) of @entity1 with normal sIgG4 reached therapeutic target (disease activity score of 28 joints < 3.2) at 6-month visit (   (2) = 6.508, P = 0.011). IgG4-positive plasma cell count correlated positively with sIgG4, total @entity603 score, and CD3-, @entity2225 -, and @entity3053 -positive cell counts (all P < 0.05). Conclusions. Our results showed that elevated sIgG4 in @entity309 is common and disproportional to total IgG and @entity309 with elevated sIgG4 may be a specific clinical phenotype with higher disease activity, higher level of autoantibodies, and poor response to @entity1499 and @entity6963 therapy.
