Characteristics of IgG4-related disease complicated with allergic rhinitis or chronic rhinosinusitis: a large cross-sectional cohort study

Abstract

In clinical practice, we found that IgG4-related disease (IgG4-RD) patients complicated with allergic rhinitis (AR)/chronic rhinosinusitis (CRS) seemed to have unique characteristics different from patients with IgG4-RD alone. In this study, demographic, clinical and laboratory characteristics of IgG4-RD patients complicated with AR/CRS were investigated. We retrospectively analyzed 756 IgG4-RD patients who were recruited in four medical centers from 2009 to 2021. We divided 756 IgG4-RD patients into 2 groups: the case group included IgG4-RD patients complicated with AR/CRS, and the control group included IgG4-RD patients without AR/CRS. 411 patients were complicated with AR/CRS among 756 IgG4-RD patients. Multiple organs involvement (≥ 3, p < 0.0001, OR 3.585 (95% CI 2.655–4.839)) and other types of allergic disease (p < 0.0001, OR 2.007 (95% CI 1.490–2.693)) were more common in the case group. Patients in the case group had a higher level of serum IgG4 (650 mg/dL vs 385 mg/dL, p < 0.0001), IgE (347 mg/dL vs 98 mg/dL, p < 0.0001) and ESR (14 mm/h vs 12 mm/h, p < 0.05). High IgE level (p < 0.01, OR 1.003 (95% CI 1.001–1.005)) and other types of allergic disease (p < 0.05, OR 3.196 (95% CI 1.146–8.908)) were risk factors for patients in the case group, in which most patients had nasal manifestations before the diagnosis of IgG4-RD. The median time interval from nasal symptoms appearance to IgG4-RD diagnosis was − 120 and − 90 months for patients complicated with AR and CRS, respectively. IgG4-RD patients are often complicated with AR/CRS and have distinct characteristics, which appear to be a subgroup of IgG4-RD. The data suggests a pathogenic association of IgG4-RD and AR/CRS.

Comorbidities and causes of hospitalizations in a cohort of IgG4‐related disease patients from a single center

“…Furthermore, patients with IgG4-RD and allergic rhinitis/chronic rhinosinusitis have been associated with multipleorganinvolvement,andhigherIgG4andIgElevels. 11 Infact, in IgG4-RD patients, a progressive increase in allergy with higher serum IgG4 levels was reported, with 60% prevalence in patients withthehighestlevels. 12 Wealsofoundorgan-specificautoimmunityin11.2%ofpatients andsystemicautoimmunediseasein7.8%.However,otherstudies have reported a lower prevalence of autoimmunity (5.1%-7.6%).…”

“…Nevertheless, patients with IgG4‐RD and allergy show some peculiarities, such as belonging more frequently to the head and neck phenotype, 9 whereas our study observed a tendency toward more allergy in the Mikulicz/systemic group. Furthermore, patients with IgG4‐RD and allergic rhinitis/chronic rhinosinusitis have been associated with multiple organ involvement, and higher IgG4 and IgE levels 11 . In fact, in IgG4‐RD patients, a progressive increase in allergy with higher serum IgG4 levels was reported, with 60% prevalence in patients with the highest levels 12 …”