Detection of IgG4 and autoantibodies in patients with orbital disease of unknown origin / 中华检验医学杂志

ABSTRACT

Objective To detect the serum IgG4 and autoantibodies levels in patients with orbital disease of unknown reasons,and to investigate their values in patients with orbital disease.Methods A total of 366 patients with orbital disease of unknown reasons recruited in the Department of Ophthalmology,Beijing Tongren Hospital Affiliated to Capital Medical University from October 2013 to October 2016 were retrospectively enrolled as orbital disease group,and 266 patients with autoimmune disease in the same period from the Department of Rheumatology of the hospital were selected as controls.The serum IgG4 was detected by rate scattering method,antinuclear antibody(ANA),anti-double-stranded DNA(dsDNA)antibody as well as anti-extractable nuclear antigen(ENA)antibody were measured by indirect immunofluorescence assay,and anti-neutrophil cytoplasmic antibody(ANCA)was detected by enzyme linked immunosorbent assay,all of which were compared between the orbital disease patients and the controls using chi-square test.Results The positive rate of the serum IgG4 in the patients with orbital disease was 36.1％(132/366),obviously higher than that in the controls(27.1％,72/266),the difference being statistically significant(x2 =5.705,P=0.017).And the positive rate of serum IgG4≥1 350 mg/L(29.0％,106/366)in the patients with orbital disease was higher than that in the controls(21.8％,58/266; x2 =4.107,P=0.043).The positive rate of ANA in the patients with orbital disease was 17.8％(65/366),obviously lower than that in the controls(28.6％,76/266),the difference also being statistically significant(x2 =10.389,P=0.001).The positive rate of anti-ENA antibody in the patients with orbital disease was 4.6％(17/366),also obviously lower that that in the controls(9.0％,24/266),with statistically significant difference as well(x2 =4.866,P=0.027).No anti-dsDNA antibody was detected in the patients with orbital disease.Only three patients with orbital disease(0.8％,3/366)were found ANCA positive,and no statistically significant difference was found in comparison with the controls(3.0％,8/266; x2 =3.127,P=0.077).Conclusions Elevated IgG4 level was commonly seen in the patients with orbital disease,where as autoantibodies were negative in the most of the patients,indicating that IgG4 might correlate with orbital disease,and part of orbital disease may belong to the IgG4-related orbital disease.