Table 2.
Cases showing overlap features between IgG4-TIN and TIN of autoimmune diseases
| Age | Sex | Serum IgG (mg/dL) | Serum IgG4 (mg/dL) | Antibody | SCr (mg/dL) | Proteinuria | Systemic complications | IgG4/HPF | IgG4/IgG (%) | IF | EM | Diagnosis of kidney biopsy | Reference | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| lgG4-RD and Sjogren's syndrome | 49 | F | 6,000 | 2,790 | Anti-SS-A (1:16) | - | - | Chronic hepatitis (3), portal hypertension (2), retroperitoneal ficrosis (1), renal involve (1) | 21.7 | 42.1 | - | - | - | Yamamoto et al. [47] |
| 43 | F | 1,898 | 188 | Anti-SS-A (1:16) | - | - | - | - | - | - | - | |||
| 48 | F | 3,009 | 768 | Anti-SS-A (1:4) | . | . | 11.3 | 23.5 | . | . | . | |||
| 56 | F | 1,890 | 694 | Anti-SS-A (1:16) | - | - | 9.7 | 19.4 | - | - | - | |||
| 59 | M | 1,880 | 339 | Anti-SS-A (1:64) | - | - | - | - | - | - | - | |||
| 73 | M | 1,912 | 374 | Anti-SS-A (1:16) | - | - | 6.7 | 21.3 | - | - | - | |||
| 61 | M | 2,558 | 774 | Anti-SS-A (1:16) | - | - | 14.7 | 33.4 | - | - | - | |||
| lgG4-RD and Sjogren's syndrome | 62 | F | 8,478 | 647 | ANA (1:10,240, homogeneous), anti-SS-A (+), anti-SS-B (+) | 0.92 | 0.82 g/gCr | General malaise, dry mouth, Raynaud’s phenomenon, anemia, lower extremity weakness, hypergammaglobulinemia | 15 | - | No immunoglobulin or complement deposition | - | Chronic plasma cell-rich TIN | Kawano et al. [45] |
| lgG4-RD and Churg-Strauss Syndrome | 68 | F | 1,997 | 275 | ANCA (–), anti–SS-A (–), RF (+) | 0.9 | 1.2 g/day | Asthma, multifocal pulmonary infiltrates, marked eosinophilia, a rash on feet, right median nerve paralysis, salivary gland swelling | - | 10 | IgG, C3 (granular, capillary), lgG1, lgG4 (+) | Electron-dense to electron-lucent subepithelial deposits in glomerular capillary walls | MGN (stage lll-IV) with eosinophil-rich TIN | Ayuzawa et al. [53] |
| IgG4-RD and Lupus nephritis | 71 | F | lgG1:1,230, lgG2:735, lgG3:418 | 37.1 | ANA (1.320 homogeneous) | 9.65 | 2.6 g/day | Abdominal pain, vomiting, diarrhea, epigastric tenderness, bilateral lower extremity pitting edema, marked leukocytosis, hypoalbuminemia, no skin changes | 13 | - | IgG, K, L (2+, granular, mesangial), IgM, IgA, C3 (1+, granular, mesangial) | Small paramesangial and scattered small electron dense to electron lucent subepithelial and intramembranous deposits | IgG4-related TIN with MGN, and/or lupus membranous nephritis with TIN | Zaarour et al. [54] |
| ANCA (–), anti–SS-A (–), anti–SS-B (–), anti-dsDNS (–), anti-Sm (–), anti-GBM (–) |
IgG4-TIN, tubulointerstitial nephritis with dominant IgG4-positive cell infiltrate; SCr, serum creatinine; HPF, high-power field; IF, immunofluorescence; EM, electron microscopy; IgG4-RD, IgG4-related disease; ANA, antinuclear antibodies; TIN, tubulointerstitial nephritis; ANCA, anti-neutrophil cytoplasmic antibody; RF, rheumatoid factor; MGN, membranous nephropathy; GBM, glomerular basement membrane; K. kappa light chain; L, lambda light chain.