IgG4-RD and allergies: Practical tips

IgG4-related disease (IgG4-RD) and allergies, which can cause similar symptoms, often overlap. This can make it challenging to determine whether certain symptoms are caused by IgG4-RD inflammation or a true allergy.

Managing allergies with IgG4-RD usually means taking a broad approach that includes working closely with your care team and making some lifestyle adjustments. Learning how to track and manage allergy-like symptoms can help you feel more in control and better supported in your care.

Understanding IgG4-RD and allergies

IgG4-RD is an immune-mediated disease that can cause inflammation and damage in virtually any tissue or organ in the body, including those affected by allergies such as the eyes, nose, and lungs.

Some IgG4-RD symptoms, such as congestion, coughing, or itchy eyes, can, therefore, resemble those of allergies, but in the absence of an allergy trigger. However, many people with IgG4-RD do have allergic diseases such as asthma, rhinitis, and urticaria.

IgG4-RD and allergies share overlapping immune features, including high levels of certain immune cells, such as eosinophils, specific antibodies, including IgG4, and activation of a type of immune response known as Th2.

Differentiating between IgG4-RD symptoms and allergies can help your care team tailor your treatment plan with greater accuracy, potentially leading to better outcomes.

Track allergy-like symptoms daily

Because allergy-like symptoms in IgG4-RD can resemble seasonal or environmental allergies, you may want to start tracking them in a daily symptom diary.

Consider recording when symptoms appear and how long they last, as well as whether they occur after exposure to common allergy triggers, such as pollen, pets, and changes in weather.

Symptom tracking can also help you identify IgG4-RD flare triggers. This information can then help your care team better address all your symptoms.

Share concerns with your care team

If you experience any allergy-like symptoms associated with IgG4-RD, report them to your care team. Bring your symptom notes to the appointment and try to be thorough and specific when describing your symptoms.

Depending on whether these are caused by an allergy trigger or not, your doctor may refer you to an allergist who specializes in allergy management for chronic conditions. The specialist may choose to recommend safe allergy medications that do not promote broad immunosuppression.

You should also contact your doctor right away if you experience any of these symptoms:

• sudden swelling
• breathing trouble
• vision changes
• worsening sinus pain
• persistent fever

Reduce home allergy triggers

Managing indoor triggers can help prevent symptoms associated with allergic reactions. You can do this by:

• using a HEPA air purifier in your bedroom and main living areas
• limiting exposure to smoke and strong scents
• avoiding carpets and heavy drapes
• vacuuming your home once or twice a week
• having a professional examine your home for mold
• keeping pets out of the bedroom if you’re allergic to pet dander

Include anti-inflammatory foods and habits

An anti-inflammatory diet that supports your immunity with IgG4-RD can complement your treatment plan.

Try to eat a combination of vegetables, fruits, lean protein, whole grains, and healthy fats to support your overall health. Avoid ultra-processed foods, such as chips, hot dogs, and sugary cereals, as these have been linked to increased inflammation in studies done in the general population.

Additionally, your IgG4-RD doctor may refer you to a nutritionist or a registered dietitian for further guidance.

Finally, other IgG4-RD wellness tips, such as getting enough sleep, drinking enough water, and managing stress through meditation, may help support your immune system and IgG4-RD management.

Manage seasonal and environmental allergies

If you have seasonal or environmental allergies, certain lifestyle modifications can be helpful, in addition to your treatment plan.

Seasonal and environmental allergy-management tips include:

• Check the pollen count daily and consider it when planning your day.
• Avoid being outside during peak pollen hours.
• Wear a mask and sunglasses outdoors.
• Shower and change your clothes after being outside.
• Avoid opening windows at home.
• Keep your car windows and sunroof closed while driving.
• Wash your bedding in hot water at least once a week.

Overall, living with IgG4-RD can involve allergy-like symptoms that may come from the disease itself or from separate allergic conditions. Learning about their causes and ways to manage them can help you and your care team reduce triggers, recognize flares early, and improve your quality of life.