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      Increased immunoglobulin (Ig) G4-positive plasma cell density and IgG4/IgG ratio are not specific for IgG4-related disease in the skin.

      American journal of clinical pathology
      Humans, Immune System Diseases, diagnosis, immunology, Immunoglobulin G, Plasma Cells, Skin Diseases

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          Abstract

          Immunoglobulin (Ig) G4-related disease (IgG4-RD), a fibroinflammatory condition that can affect multiple organs, is suggested by lymphoplasmacytic inflammation, fibrosis, phlebitis, and increased IgG4+ plasma cell (PC) tissue density. In patients with suspected IgG4-RD and skin changes, skin biopsy may serve as a diagnostic screen or to supplement nondiagnostic visceral biopsy specimens. We aimed to determine whether increased cutaneous IgG4+ PCs or IgG4/IgG ratio is specific for IgG4-RD. We examined 50 mucocutaneous specimens representing seven PC-rich dermatoses and reactive PC-rich infiltrates with IgG and IgG4 immunohistochemical stains. IgG4+ density exceeded 10 cells per high-power field in 22 (44%) of 50 specimens, representing six of seven diagnoses and reactive infiltrates. In five specimens (10%), the IgG4/IgG ratio exceeded 0.40. Moderately elevated IgG4+ PC density or IgG4/IgG ratio is a nonspecific finding in the skin. In cutaneous biopsy specimens showing increased IgG4+ PCs, careful consideration should be given to clinical, serologic, and other histopathologic features before attributing clinical changes to IgG4-RD.

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          Author and article information

          Journal
          24436271
          10.1309/AJCPTMWTCN04GSJH

          Chemistry
          Humans,Immune System Diseases,diagnosis,immunology,Immunoglobulin G,Plasma Cells,Skin Diseases
          Chemistry
          Humans, Immune System Diseases, diagnosis, immunology, Immunoglobulin G, Plasma Cells, Skin Diseases

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