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Serum I mmunoglobulin G 4 levels are elevated in patients with G raves’ ophthalmopathy
Author(s) -
Bozkirli Emre,
Bakiner Okan Sefa,
Ersozlu Bozkirli Emine Duygu,
Eksi Haydardedeoglu Filiz,
Sizmaz Selcuk,
Torun Aysenur Izol,
Ertorer Melek Eda
Publication year - 2015
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12671
Subject(s) - medicine , graves' ophthalmopathy , thyroiditis , endocrinology , graves' disease , thyroid , gastroenterology
Summary Objective Recent studies have shown close association between serum I mmunoglobulin G 4 ( I g G 4) levels and forms of autoimmune thyroiditis. However, there are limited data about the relationship between I g G 4 and G raves’ ophthalmopathy ( GO ). In the present study, we aimed to determine the possible association between I g G 4 and GO . Design Cross‐sectional study. Patients Sixty‐five patients with G raves’ disease ( GD ) and 25 healthy controls were recruited into the study. Thirty‐two of these patients had GO . Measurements Serum I g G 4 levels, thyroid functions and thyroid volumes were measured in all participants. Ophthalmological examination including H ertel's exophthalmometer readings ( HER ), Schirmer's test ( ST ), ‘ NO SPECS ’ classification and clinical activity score evaluation ( CAS ) were performed to all patients with GD . Results I g G 4 levels were significantly elevated in patients with G raves’ disease compared to controls ( P = 0·0001). Also, I g G 4 levels were significantly higher in patients with and without GO when compared to control subjects ( P = 0·0001 and P = 0·002, respectively). Furthermore, I g G 4 levels were significantly higher in the GO group compared with GD patients without GO ( P = 0·024). I g G 4 levels were observed to increase in parallel to CAS . Compared with other GD patients, 15 GD patients with serum I g G 4 levels ≥135 mg/dl had higher CAS scores ( P = 0·012). None of the factors including, TSH , T 3, T 4 levels, thyroid volume, HER and ST measurements, affect I g G 4 levels as an independent factor. Conclusion I g G 4 levels are evidently increased in patients with GD , and there is a possible relationship between I g G 4 and GO . Our results suggest that I g G 4 may be helpful in screening GD patients with high risk for GO and may well become a good indicator for the selection of right medication in the future.