Detection of Polyclonal Increases in Immunoglobulin G4 Subclass by Distinct Patterns on Capillary Serum Protein Electrophoresis:  Diagnostic Pitfalls and Clinical Observations in a Study of 303 Cases

Autoimmunity, hypersensitivity, and the recently recognized set of syndromes collectively termed immunoglobulin G4-related disease (IgG4-RD) may be associated with increased serum IgG4 levels. We reviewed our experience detecting increased IgG4 by distinct serum protein electrophoresis (SPEP) patter...

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Bibliographic Details
Published in:American journal of clinical pathology 2016-09, Vol.146 (3), p.303-311
Main Authors: Finn, William G, Gulbranson, Ronald, Fisher, Sondra, Rae Sample, Lynn, Shalhoub, Renee, Hedstrom, Deborah, Keren, David F
Format: Article
Language:English
Subjects:
Autoimmune Diseases - diagnosis
Autoimmune Diseases - immunology
Complement C3 - analysis
Complement C4 - analysis
Diagnosis, Differential
Electrophoresis, Capillary - methods
Humans
Immunoglobulin G - analysis
Immunoglobulin G - immunology
Isoelectric Focusing - methods
Paraproteinemias - diagnosis
Paraproteinemias - immunology
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Summary:Autoimmunity, hypersensitivity, and the recently recognized set of syndromes collectively termed immunoglobulin G4-related disease (IgG4-RD) may be associated with increased serum IgG4 levels. We reviewed our experience detecting increased IgG4 by distinct serum protein electrophoresis (SPEP) patterns. We studied 303 capillary SPEP cases with dome-like anodal γ changes and increased measured serum IgG4. IgG4 ranged from 208 to 6,670 mg/dL (normal, 
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqw113