![]() ![]() In the present case, an autoimmune antibody test and a serum complement test were performed to differentiate systemic lupus erythematosus and Sjogren syndrome, which may also accompany lymph node enlargement. If the ratio of IgG4 plasma cell/IgG plasma cell is higher than 40% in all the organs, an IgG4-related disease may be diagnosed. 3 Since the IgG4 plasma cell/HPF ratio, which enables the diagnoses of an IgG4-related disease, is dependent on the affected organs, some researchers employ the ratio of IgG4 plasma cell/IgG plasma cell as the reference for the diagnosis. The IgG4 plasma cell/HPF ratio, which enables an IgG4-related disease to be diagnosed on the basis of the biopsy result, is dependent on the affected organs. 7 However, even when the serum IgG4 level is within the normal range, an IgG4-related disease may be diagnosed with reference to the ratio of IgG4 plasma cell/HPF. 5 Another study showed that the IgG4 level was increased as the number of affected organs was increased. According to a report, 86% of 114 IgG4-related disease patients showed a serum IgG4 level higher than 135 mg/dl, the normal upper limit. 2 As the name implies, many of the IgG4-related disease patients show an increase in their serum IgG4 level. 2 The basic requirements of the diagnosis of an IgG4-related disease are the serum IgG4 level test and the biopsy of affected organs, and radiological tests may also be performed depending on the affected organs. IgG4-related disease, which is a disease caused by the infiltration of IgG4 positive plasma cells into various target organs, is characterized by the infiltration into multiple organs including the pancreas, the kidneys, and the salivary glands. ![]()
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