Disparities between IgG4-related kidney disease and extrarenal IgG4-related disease in a case-control study based on 450 patients

Sci Rep. 2021 May 17;11(1):10397. doi: 10.1038/s41598-021-89844-7.

Abstract

We aimed to compare the demographic, clinical and laboratory characteristics between IgG4-related kidney disease (IgG4-RKD+) and extrarenal IgG4-related disease (IgG4-RKD-) in a large Chinese cohort, as well as describing the radiological and pathological features of IgG4-RKD+. We retrospectively analyzed the medical records of 470 IgG4-related disease (IgG4-RD) patients at Peking University People's Hospital from January 2004 to January 2020. The demographic, clinical, laboratory, radiological and pathological characteristics between IgG4-RKD+ and IgG4-RKD- were compared. Twenty IgG4-RD patients who had definite etiology of renal impairment including diabetes, hypertension and etc. were excluded. Among the remained 450 IgG4-RD patients, 53 were diagnosed with IgG4-RKD+ . IgG4-RKD+ patients had older age at onset and at diagnosis. Male to female ratio of IgG4-RKD+ patients is significantly higher. In the IgG4-RKD+ group, the most commonly involved organs were salivary gland, lymph nodes and pancreas. It was found that renal function was impaired in approximately 40% of IgG4-RKD+ patients. The most common imaging finding is multiple, often bilateral, hypodense lesions. Male sex, more than three organs involved, and low serum C3 level were risk factors for IgG4-RKD+ in IgG4-RD patients. These findings indicate potential differences in pathogenesis of these two phenotypes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Case-Control Studies
  • Complement C3 / genetics
  • Diabetes Complications / blood
  • Diabetes Complications / diagnostic imaging
  • Diabetes Complications / pathology
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnostic imaging
  • Female
  • Humans
  • Hypertension / blood
  • Hypertension / complications
  • Hypertension / diagnostic imaging
  • Hypertension / pathology
  • Immunoglobulin G / blood*
  • Immunoglobulin G / genetics
  • Immunoglobulin G4-Related Disease / blood
  • Immunoglobulin G4-Related Disease / complications
  • Immunoglobulin G4-Related Disease / diagnostic imaging
  • Immunoglobulin G4-Related Disease / genetics*
  • Kidney / diagnostic imaging
  • Kidney / pathology
  • Kidney Diseases / blood
  • Kidney Diseases / complications
  • Kidney Diseases / genetics*
  • Kidney Diseases / pathology
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging
  • Pancreas / pathology
  • Renal Insufficiency / blood*
  • Renal Insufficiency / diagnostic imaging
  • Renal Insufficiency / genetics
  • Renal Insufficiency / pathology
  • Retrospective Studies
  • Salivary Glands / diagnostic imaging
  • Salivary Glands / pathology
  • Tomography, X-Ray Computed

Substances

  • C3 protein, human
  • Complement C3
  • Immunoglobulin G