IgG4-RD patients with allergy history are more likely to relapse: Study
Differences in disease's age at onset, impact also found for those with allergies
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People with IgG4-related disease (IgG4-RD) who have a history of allergies are more likely to relapse after initial treatment, according to a recent study.
Data also suggest that demographic variables and patterns of disease involvement differ between IgG4-RD patients with or without allergies. Specifically, individuals with a history of allergies are more likely to be younger when IgG4-RD symptoms start, though they’re less likely to see involvement with one of the body’s organs.
“IgG4-RD patients with allergy history have distinctive [disease manifestations] and prognosis. Therefore, differentiated treatment strategies and novel medications are required for them,” the researchers wrote.
The study, “Clinical phenotypes and prognosis of IgG4-RD patients with allergy history: A retrospective cohort study,” was published in the journal Clinical Rheumatology.
IgG4-RD is a disorder marked by abnormal clumps of immune cells that can form in organs throughout the body.
Rates of allergies, asthma are higher in people with IgG4-RD
Previous studies have shown that rates of allergies and asthma are higher among IgG4-RD patients than in the general population, suggesting that these diseases may be linked at least in some cases. However, there’s little data on how IgG4-RD tends to manifest in people with allergies versus those without them.
To learn more, scientists in China analyzed data from 215 IgG4-RD patients who were treated at their clinic in Beijing.
Slightly more than a third (37.7%) of the patients had a history of allergies, while the rest did not. The scientists ran a battery of statistical tests to compare these two groups.
“We conducted a retrospective case-control study based on our cohort of patients with IgG4-related diseases, thoroughly comparing the demographic, clinical characteristics, laboratory parameters, and treatment outcomes between patients with and without allergies,” the scientists wrote.
The results revealed several demographic differences. Individuals with allergies tended to be younger at the time of disease onset than those without allergies (median age of 56 vs. 60 years). Most patients in both groups were male, but the proportion of males was significantly lower among patients with allergies (58% vs. 73.1%).
There were also differences in patterns of disease involvement. Individuals with a history of allergies were more likely to have IgG4-RD affecting two or more sets of glands, such as the tear and salivary glands. By comparison, rates of disease involvement in the pancreas were higher among patients who did not have a history of allergies.
Lab tests also showed differences, with higher percentages of eosinophils, a type of immune cell, being seen in patients with a history of allergies.
Time to relapse was shorter for patients with allergy history
Outcome data were available for 148 patients. Nearly all were treated with glucocorticoids, sometimes in combination with other immunosuppressing therapies. In all of these patients, initial treatment successfully brought the disease into remission.
The researchers then compared the rates of relapse, or disease recurrence, following initial treatment.
These results showed that relapse rates were higher among patients with a history of allergies (63.2% vs. 48.5%). The time to relapse also tended to be shorter among those with an allergy history.
It is vital to focus on [the] distinctive features of IgG4-RD patients with [an] allergy history and explore novel treatment for them.
The team noted that prior studies have indicated that IgG4-RD in the tear and salivary glands is more likely to relapse than in any other organs. As such, it’s possible that the higher rate of relapses seen in patients with allergies could be explained by the fact that these patients more often had disease involvement in these glands.
It’s also possible that allergy-related disease processes could be contributing to worsening IgG4-RD activity, the researchers noted.
The scientists stressed that more research is needed to understand the links between IgG4-RD and allergy, noting that this study was limited to a review of patients at a single center.
“It is vital to focus on [the] distinctive features of IgG4-RD patients with [an] allergy history and explore novel treatment for them,” the team concluded.
