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Martín-Nares E, Hernández-Molina G, Baenas DF, Delgado de la Mora J, Caeiro F, Wurmann Kiblisky P, Pimentel-Quiroz VR, Ascuña Valdivia V, Faz-Munoz D, Saad EJ, Cairoli E, Elgueta Pinochet S, Madariaga Charaja H, Montante-Montes de Oca D, Gallo JR, Ugarte-Gil MF, Neira O, Burgos PI, Paira S. Performance of the 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria for IgG4-Related Disease in a Latin American Cohort. J Clin Rheumatol 2024; 30:52-57. [PMID: 38206921 DOI: 10.1097/rhu.0000000000002052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND/OBJECTIVE The 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria (2019 AECC) for IgG4-related disease (IgG4-RD) is considered a significant advancement in the study of this condition. Most studies evaluating their performance have focused on White and Asian patients, leaving a knowledge gap regarding Latin American populations. Therefore, this study aimed to assess the performance of the 2019 AECC for IgG4-RD in a cohort of Latin American patients. METHODS A multicenter medical records review study was conducted, involving centers from Argentina, Chile, Mexico, Peru, and Uruguay. Data on IgG4-RD patients and mimicker conditions were collected through a standardized online form. The criterion standard for diagnosing IgG4-RD was based on the fulfillment of the Comprehensive Diagnostic Criteria for IgG4-RD and/or the Consensus Statement on Pathology. The 2019 AECC was retrospectively applied. RESULTS We included 300 patients, with 180 (60%) having IgG4-RD and 120 (40%) having mimicker conditions. The 2019 AECC had a sensitivity of 66.7% and a specificity of 100%. Sensitivity increased to 73.3% when disease-specific autoantibody items were removed, without affecting specificity. The true-positive cases had more involved organs, a higher availability of biopsy results, and were more likely to belong to the Mikulicz/systemic and proliferative phenotypes. CONCLUSIONS The use of the 2019 AECC for IgG4-RD in a Latin American population confirms its high specificity in excluding those without the disease. The presence of concomitant autoimmune diseases and clinically nonsignificant disease-specific autoantibodies excludes a significant number of patients from fulfilling the criteria.
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Affiliation(s)
- Eduardo Martín-Nares
- From the Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Gabriela Hernández-Molina
- From the Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Diego Federico Baenas
- Department of Rheumatology, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Jesús Delgado de la Mora
- Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Francisco Caeiro
- Department of Rheumatology, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Pamela Wurmann Kiblisky
- Departamento de Medicina, Sección Reumatología, Hospital Clínico Universidad de Chile, Santiago, Chile
| | | | | | - David Faz-Munoz
- From the Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Emanuel José Saad
- Departamento de Clínica Médica, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | | | - Sergio Elgueta Pinochet
- Servicio de Reumatología, Clínica Alemana de Valdivia, Instituto de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | | | | | - Jesica Romina Gallo
- Sección de Reumatología, Hospital Central de Reconquista, Reconquista, Argentina
| | | | | | - Paula I Burgos
- Departamento de Inmunología Clínica y Reumatología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sergio Paira
- Sección de Reumatología, Hospital José María Cullen, Santa Fe, Argentina
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