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. 2022 Jul;74(7):1188-1195.
doi: 10.1002/acr.24545. Epub 2022 Apr 6.

Lifetime Allergy Symptoms in IgG4-Related Disease: A Case-Control Study

Samantha Sanders  1 , Xiaoqing Fu  2 , Yuqing Zhang  3 , Cory A Perugino  3 , Rachel Wallwork  2 , Emanuel Della-Torre  4 , Liam Harvey  3 , Tyler Harkness  3 , Aidan Long  3 , Hyon K Choi  3 , John H Stone  3 , Zachary S Wallace  3
Affiliations

Lifetime Allergy Symptoms in IgG4-Related Disease: A Case-Control Study

Samantha Sanders et al. Arthritis Care Res (Hoboken). 2022 Jul.

Abstract

Objective: The etiology of IgG4-related disease (IgG4-RD) is unknown, and there has been controversy over the significance of allergic conditions in IgG4-RD. We examined the prevalence of lifetime allergy symptoms in IgG4-RD and the association between these and IgG4-RD.

Methods: We identified IgG4-RD patients and non-IgG4-RD controls without autoimmune conditions seen at a single center. IgG4-RD patients were classified using the American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria. Allergy symptoms were ascertained by questionnaire. We assessed the association of IgG4-RD features with allergy symptoms. We compared the proportion of cases and controls with allergy symptoms using conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) after matching cases and controls 1:1 by age and sex.

Results: Lifetime allergy symptoms were reported by 165 (71%) of 231 IgG4-RD patients. Aeroallergen symptoms were most commonly reported (n = 135, 58%), followed by skin allergy symptoms (n = 97, 42%) and food allergy symptoms (n = 47, 20%). IgG4-RD cases with a history of allergy symptoms were more likely to have head and neck involvement (OR 2.0 [95% CI 1.1-3.6]) and peripheral eosinophilia (OR 3.3 [95% CI 1.2-9.0]) than those without allergy symptoms. The prevalence of any allergy symptoms was similar between cases and controls (OR 0.7 [95% CI 0.4-1.1]); this remained consistent after stratifying by head and neck involvement.

Conclusion: Lifetime allergy symptoms are common in IgG4-RD but are not reported more often in IgG4-RD compared to non-IgG4-RD patients without autoimmune conditions. These findings suggest that allergies are not uniquely associated with the pathogenesis or presentation of IgG4-RD.

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