title: Diagnostic performance of serum IgG4 level for IgG4-related disease: a meta-analysis.
abstract: An elevated serum IgG4 level is one of the most useful factors in the diagnosis of IgG4-related disease (IgG4-RD). In this study, we performed a meta-analysis of the published articles assessing the diagnostic accuracy of serum IgG4 concentrations for IgG4-RD. The databases of MEDLINE/PubMed, EMBASE and Web of Science were systematically searched for relevant studies. Sensitivities and specificities of serum IgG4 in each study were calculated, and the hierarchical summary receiver operating characteristic (HSROC) model with a random effects model were employed to obtain the individual and pooled estimates of sensitivities and specificities. In total, twenty-three studies comprising 6048 patients with IgG4-RD were included in the meta-analysis. The pooled sensitivity was 85% with a 95% confidence interval (CI) of 78-90%; the pooled specificity was 93% with a 95% CI of 90-95%. The HSROC curve for quantitative serum IgG4 lies closer to the upper left corner of the plot, and the area under the curve (AUC) was 0.95 (95% CI 0.93, 0.97), which suggested a high diagnostic accuracy of serum IgG4 for the entity of IgG4-RD. Our study suggests that serum IgG4 has high sensitivity and specificity in the diagnosis of IgG4-RD.
authors: Department of Clinical Laboratory, Baoshan Branch of Shanghai Huashan Hospital, Baoshan Renhe Hospital, Shanghai 200431, China.
authors: Wen-Long
authors: WL
authors: Xu
authors: Department of Clinical Laboratory, Shaoxing Seventh People's Hospital, Zhejiang Shaoxing 312000, China.
authors: Ying-Chun
authors: YC
authors: Ling
authors: Department of Clinical Laboratory, Shanghai Family Planning Hospital, Shanghai 200032, China.
authors: Zhi-Kai
authors: ZK
authors: Wang
authors: Department of Clinical Laboratory, Anhui Provincial Tumor Hospital, Anhui Hefei 230031, China.
authors: Fang
authors: F
authors: Deng
mesh_terms: D015209:Cholangitis, Sclerosing / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008882:Mikulicz' Disease / Q000097:blood / Q000175:diagnosis*; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012793:Sialadenitis / Q000097:blood / Q000175:diagnosis*
chemical_list: D007074:Immunoglobulin G