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IgG4 serum levels in Graves’ orbitopathy

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Abstract

Objective

IgG4-related disease (IgG4-RD) can involve many organs, including thyroid and orbital tissues. A link between IgG4, Graves’ disease (GD) and Graves’ orbitopathy (GO) has been proposed, but results are conflicting. Here we investigated the possible association between IgG4 and GO.

Methods

Retrospective investigation in 297 patients with Graves’ disease (GD), 152 with GO. Primary outcome: prevalence of IgG4 ≥ 135 mg/dL (cut-off for IgG4-RD). Secondary objectives: (1) serum IgG4 concentrations; (2) IgG4/IgG ratio; (3) prevalence of IgG4/IgG ratio ≥ 8.0%; (4) relationship between IgG4 and eye features; (5) relationship between IgG4 and anti-TSH receptor antibodies (TRAbs).

Results

Because GO patients had lower FT3 concentrations, we evaluated the main objectives in the second and third FT3 quartiles subpopulation, in which there were no relevant differences between patients with (n = 81) or without GO (n = 67) for baseline parameters. Within this population, the prevalence of IgG4 levels ≥ 135 mg/dL did not differ between patients without and with GO (17.9% vs 17.3%). No difference was observed concerning IgG4 concentrations, prevalence of IgG4/IgG ≥ 8.0%, and IgG4/IgG ratio. There was no relationship between IgG4 and eye features and no correlation between IgG4 levels and TRAb was found.

Conclusions

Our results suggest that, within GD, there is no relationship between serum IgG4 and GO.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Simone Comi and Giulia Lanzolla equal contribution.

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy

    S. Comi, G. Lanzolla, G. Cosentino, F. Menconi, F. Santini, R. Elisei & M. Marinò

  2. Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    G. Lanzolla

  3. Department of Surgical, Medical and Molecular Pathology, Ophthalmology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy

    M. N. Maglionico & C. Posarelli

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  1. S. Comi
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Correspondence to M. Marinò.

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The authors declare that they have no conflict of interest. Michele Marinò is a member of the Journal of Endocrinological Investigation Editorial Board.

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Informed consent was obtained from the individual participant included in the study.

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The study was performed according to Institutional guidelines. Approval was not required. All procedure performed in the study involving human participants were in accordance with the ethical standards of th

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Comi, S., Lanzolla, G., Cosentino, G. et al. IgG4 serum levels in Graves’ orbitopathy. J Endocrinol Invest (2023). https://doi.org/10.1007/s40618-023-02265-3

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