Prevalence of atopy, eosinophilia, and IgE elevation in IgG4-related disease

Authors

  • E. Della Torre,

    1. Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
    2. Unit of Medicine and Clinical Immunology, School of Medicine, Università Vita-Salute San Raffaele, Milan, Italy
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    • These authors contributed equally.
  • H. Mattoo,

    1. Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
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    • These authors contributed equally.
  • V. S. Mahajan,

    1. Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
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  • M. Carruthers,

    1. Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA, USA
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  • S. Pillai,

    Corresponding author
    1. Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
    • Correspondence

      John H. Stone, Rheumatology,

      Massachusetts General Hospital,

      55 Fruit Street,

      Boston, MA 02114,

      USA.

      Tel.: 617-726-7938

      Fax: 617-643-1274

      E-mail: jhstone@partners.org

      or

      Shiv Pillai, MGH Cancer Center,

      149, 13th Street, Charlestown, MA 02129,

      USA.

      Tel.: 617-726-5619

      Fax: 617-724-9648

      E-mail: pillai@helix.mgh.harvard.edu

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  • J. H. Stone

    Corresponding author
    1. Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA, USA
    • Correspondence

      John H. Stone, Rheumatology,

      Massachusetts General Hospital,

      55 Fruit Street,

      Boston, MA 02114,

      USA.

      Tel.: 617-726-7938

      Fax: 617-643-1274

      E-mail: jhstone@partners.org

      or

      Shiv Pillai, MGH Cancer Center,

      149, 13th Street, Charlestown, MA 02129,

      USA.

      Tel.: 617-726-5619

      Fax: 617-724-9648

      E-mail: pillai@helix.mgh.harvard.edu

    Search for more papers by this author

  • Edited by: Hans-Uwe Simon

Abstract

IgG4-related disease (IgG4-RD) is a fibroinflammatory disorder that can affect virtually every organ system. T-helper type 2 responses have been presumed to be pathogenic in this disease, and a high proportion of patients with IgG4-RD are reported to have longstanding allergies, peripheral blood eosinophilia, and serum IgE elevation. It has therefore been proposed that allergic mechanisms drive IgG4-RD. However, no epidemiological assessment of atopy, peripheral blood eosinophilia, and serum IgE concentrations has ever been undertaken in patients with IgG4-RD. In this study, we evaluated these parameters in a large cohort of patients with IgG4-RD in whom a wide range of organs were affected by disease. Our results demonstrate that the majority of patients with IgG4-RD are nonatopic. Nevertheless, a subset of nonatopic subjects exhibit peripheral blood eosinophilia and elevated IgE, suggesting that processes inherent to IgG4-RD itself rather than atopy per se contribute to the eosinophilia and IgE elevation observed in the absence of atopy.

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