Comparative Analysis of Classification Criteria in IgG4-Related Disease and Evaluating Diagnostic Accuracy from a Retrospective Cohort in Clinical Practice.

Autor: Lopez-Gomez M; Rheumatology Department, Hospital Universitario Araba, 01009 Vitoria, Spain.; Instituto de Investigación Biomédica BIORABA, Hospital Universitario Araba, 01009 Vitoria, Spain.; Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain., Moya-Alvarado P; Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Park HS; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Martín MC; Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Calleja S; Immunology Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, UAB, 08025 Barcelona, Spain., Codes-Mendez H; Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Magallares B; Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Castellví I; Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Barros-Membrilla AJ; Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Laiz A; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Diaz-Torné C; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Sainz L; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Bernárdez J; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain., Martínez-Martinez L; Immunology Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, UAB, 08025 Barcelona, Spain., Corominas H; Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.; Institut de Recerca Sant Pau (IR SANT PAU), 08041 Barcelona, Spain.; Rheumatology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2024 Nov 17; Vol. 14 (22). Date of Electronic Publication: 2024 Nov 17.
DOI: 10.3390/diagnostics14222583
Abstrakt: Introduction: We conducted a comprehensive comparative analysis of the Okazaki, Umehara, and American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for diagnosing immunoglobulin G4-related disease (IgG4-RD).
Materials and Methods: A retrospective study was conducted in a single tertiary hospital, using expert clinical judgment as the gold standard. We compared the diagnostic accuracy of the Okazaki, Umehara, and ACR/EULAR criteria in a cohort of 41 patients with suspected IgG4-RD. We assessed sensitivity, specificity, and positive and negative predictive values for each criterion, and conducted a separate analysis based on four IgG4-RD subtypes.
Results: A total of 30 patients were confirmed to have IgG4-RD and 11 were identified as mimickers. The Umehara criteria demonstrated the highest sensitivity (83.33%), followed by the ACR/EULAR 2019 (66.67%) and Okazaki (60.0%) criteria. All three criteria exhibited 100% specificity, with overall diagnostic accuracy ranging from 70% to 88%. The areas under the curve (AUC) were 0.917 (Umehara), 0.800 (Okazaki), and 0.833 (ACR/EULAR 2019), indicating significant diagnostic effectiveness ( p < 0.000). Subtype analysis revealed that the Umehara and ACR/EULAR 2019 criteria were more effective in diagnosing pancreato-hepato-biliary involvement (subtype 1), while the Okazaki and ACR/EULAR 2019 criteria were more effective in diagnosing retroperitoneal fibrosis and/or aortitis (subtype 2).
Conclusions: Our study provides valuable insights into the diagnostic performance of the Okazaki, Umehara, and ACR/EULAR criteria for a cohort of patients with suspected IgG4-RD. The Umehara criterion demonstrated the highest sensitivity, suggesting its potential utility for screening purposes, while all three criteria showed consistent specificity.
Databáze: MEDLINE
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