Association of immunoglobulin G4 and free light chain with idiopathic pleural effusion.

摘要: Summary The cause of pleural effusion remains uncertain in approximately 15% patients despite exhaustive evaluation. As recently described IgG4-related disease is a fibroinflammatory disorder that can affect various organs including the lungs, we investigate whether idiopathic includes IgG4-associated etiology. Between 2000 and 2012, collected 830 fluid samples reviewed 35 with effusions undiagnosed after biopsy at Yamaguchi-Ube Medical Center. Importantly, IgG4 immunostaining revealed infiltration IgG4-positive plasma cells pleura 12 (34%, IgG4+ group). The median level was 41 mg/dl group 27 IgG4− (P<0.01). light heavy chains antibodies were heterogeneous by two-dimensional electrophoresis, indicating absence clonality antibodies. Interestingly, κ more than λ chains. measurement free chain (FLC) levels fluids showed significantly different FLC (median, 28.0 vs. 9.1 mg/dl, P<0.01) κ/λ ratios 2.0 1.2, P<0.001) between groups. Furthermore, correlated IgG4+/IgG+ cell group. Taken together, these results demonstrate involvement certain provide insights into diagnosis, pathogenesis therapeutic opportunities effusion. This article protected copyright. All rights reserved.