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Serum Immunoglobulin G4 is a useful marker to diagnose autoimmune pancreatitis.
The results of a comprehensive systematic review and meta-analysis indicated that serum immunoglobulin G4 (sIgG4) is a valuable indicator of autoimmune pancreatitis (AIP). Shih-Ching Lee et al. aimed to explore the diagnostic utility of sIgG4 in autoimmune pancreatitis. The analysis was performed based on published research. Diagnostic odds ratios (DOR), sensitivity, specificity, and areas under summary receiver operating characteristic (ROC) curves were estimated after data were pooled using the random-effects model.
In the 13 incorporated studies, 594 individuals with AIP and 958 people with pancreatic cancer had their levels of sIgG4 tested. The pooled sensitivity, area under the curve, DOR, and specificity were 0.72, 0.91, 51.37, and 0.93 respectively. The values for subgroup assessment of the DORs for region and year were as follows: Asia (112.10), non-Asia (26.01), the year prior to 2011 (107.61), and the year after 2011 (26.96). Overall, the results showed a moderate sensitivity of 0.72 and a high specificity of 0.93 for the association between sIgG4 and AIP.
The pooled DOR of sIgG4 levels with a 2-fold upper limit of 50.44 in the meta-analysis was comparable to the DOR of 51.37 with a 1-fold cut-off value. However, the summary receiver operating characteristic was 0.755 and 0.91. The greater specificity (from 93% to 98%) procured from cut-off values (from 130-140 mg/dL to 260-280 mg/dL) for sIgG4 eventuated at a considerable decrease in sensitivity (from 72% to 43%).
According to the findings, sIgG4 is a promising indicator of AIP. Clinicians may be able to distinguish between AIP and pancreatic cancer using sIgG4 screening, and 140 mg/dL rather than 280 mg/dL is the optimal cut-off value.
Journal of Clinical Gastroenterology
Diagnostic Utility of Serum IgG4 in Autoimmune Pancreatitis: An Updated Comprehensive Systematic Review and Meta-analysis
Shih-Ching Lee et al.
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