#EULAR2022
What is New (WIN)
IgG4
🔆IgG4 is a multi-organ Disease
🔆usually >50
🔆M:F - 3:1
🔆CD4+ cytotoxic cell implicated
🔆 Classification criteria known
#EULAR2022
What is New (WIN)
IgG4
🔆➕ve correlation with smoking (IgG4 retroperitoneal fibrosis)
🔆 blue Collar Jobs have ⬆️IgG4 (pancreato biliary)
🔆d/t toxic exposures 👉🏻 asbestosis, mineral dust
#EULAR2022
What is New (WIN)
IgG4
🔆Role of AutoAb suspected
🔆Anti-IL1RA👉🏻Mediates Inflammation and fibrosis
🔆Anti-Annexin A11👉🏻 damage biliary bicarbonate umbrella
#EULAR2022
What is New (WIN)
IgG4
Role of Gut microbiota suspected
🔆 changes similar to PSC
🔆⬇️Blautia, ⬇️ Eubacterium seen in IgG4-SC
#EULAR2022
What is New (WIN)
IgG4
🔆Cluster analysis divides IgG4 in 4 Clusters
🔆Head and Neck MC in females and asians
🔆Mikulicz 👉🏻 ⬆️⬆️IgG4 levels
🔆 Renal Inv asso with ⬆️ pancreato biliary, RPF, ⬇️C3, Multisystem inv
#EULAR2022
What is New (WIN)
IgG4
Newer biomarkers being developed
🔆Plasmablast appear promising (But costly)
Acc to Machine learning
🔆IgG4 level
🔆Age
🔆Ig
🔆sIL-2R
Important variables
#EULAR2022
What is New (WIN)
IgG4
🔆Initial Rx with IS might be better
🔆50% flare by 2-3 yrs with RTX Induction
🔆Obinutuzumab in RTX resistant/Failure
#EULAR2022
What is New (WIN)
IgG4
🔆Tocilizumab 🔥>> CYC
🔆Abatacept ❌
#EULAR2022
What is New (WIN)
IgG4
🔆⬆️ malignancy risk with IgG4
🔆Lung Ca⬆️
🔆Pancreas Ca ⬆️
🔆Lymphoma ⬆️
🔆but not Gastric Ca
🔆Most diagnosed with the 1st year of IgG4 diagnosis
#EULAR2022
What is New (WIN)
IgG4
Summary
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