Observational study finds IgG4 surge predicts relapse in IgG4-related disease, indicating need for dynamic monitoring.
A paradigm shift from relying on static IgG4 levels to monitoring IgG4 dynamics is needed. The IgG4 surge defined as an IgG4-Ratio >1.6 (indicating a > 60% increase in IgG4 levels between consecutive measurements taken at median 3-month intervals) predicts relapse in the majority of seropositive IgG4-RD patients. Intensified treatment in patients with IgG4 surge can reduce recurrence risk.
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Wang et al. (2026) studied this question.
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