Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency

Mehmet Kılınç; Fatih Çölkesen; Recep Evcen; Filiz Sadi Aykan; Eray Yıldız; Tuğba Önalan; Fatma Arzu Akkuş; Şevket Arslan

doi:10.47582/jompac.1861792

Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency

Abstract

Aims: This study investigated whether baseline serum IgG4-to-IgG ratios are associated with the presence of autoimmune manifestations in patients diagnosed with common variable immunodeficiency (CVID). Methods: A retrospective cohort analysis was performed using clinical data from 85 patients with CVID evaluated between January 2013 and November 2023. The study included patients aged 18 years and over with a confirmed diagnosis of CVID. Patients with incomplete or insufficient clinical information were excluded. Serum IgG4-to-IgG ratios measured at initial assessment were compared between individuals with autoimmune manifestations and those without. Results: Of the 85 patients, 36 (42.4%) had at least one autoimmune condition. Autoimmune cytopenias constituted the most frequent autoimmune presentation (17.6%). The median IgG4-to-IgG ratio in CVID with autoimmune disease was 0.018 (interquartile range, 0.014–0.043), which was significantly lower than that observed in the group without autoimmunity (p=0.03). Building on this finding, ROC analysis identified a threshold IgG4-to-IgG ratio of 0.04 for differentiating autoimmune from non autoimmune cases (AUC 0.709; 95% CI 0.60–0.82; p=0.002; sensitivity 72%; specificity 60%). Finally, logistic regression analysis demonstrated that a reduced IgG4-to-IgG ratio was significantly associated with the development of autoimmune disease (odds ratio, 1.682; 95% confidence interval, 1.129–2.489; p=0.037). Conclusion: Lower baseline IgG4-to-IgG ratios were associated with autoimmune manifestations in CVID. This parameter may serve as a practical adjunctive biomarker for the early identification and monitoring of autoimmune complications in this heterogeneous disorder.

Keywords

Ethical Statement

The study was initiated with the approval of the Necmettin Erbakan University Medical Faculty Clinical Researches Ethics Committee (Date: 2023, Decision No: 2023/4697).

Thanks

None

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Details

Primary Language

English

Subjects

Innate Immunity, Autoimmunity

Journal Section

Research Article

Authors

Mehmet Kılınç ^*
0000-0003-1117-6872
Türkiye

Fatih Çölkesen
0000-0002-6595-1267
Türkiye

Recep Evcen
0000-0002-6124-5816
Türkiye

Filiz Sadi Aykan
0000-0002-8941-5573
Türkiye

Eray Yıldız
0000-0002-9596-1773
Türkiye

Tuğba Önalan
0000-0003-2427-5925
Türkiye

Fatma Arzu Akkuş
0000-0003-0519-7132
Türkiye

Şevket Arslan
0000-0002-0343-0159
Türkiye

Publication Date

February 20, 2026

Submission Date

January 12, 2026

Acceptance Date

February 4, 2026

Published in Issue

Year 2026 Volume: 7 Number: 1

DOI

https://doi.org/10.47582/jompac.1861792

IZ

https://izlik.org/JA29DS34CR

Cite

RIS / Bibtex

APA

Kılınç, M., Çölkesen, F., Evcen, R., Sadi Aykan, F., Yıldız, E., Önalan, T., Akkuş, F. A., & Arslan, Ş. (2026). Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency. Journal of Medicine and Palliative Care, 7(1), 133-139. https://doi.org/10.47582/jompac.1861792

AMA

1.Kılınç M, Çölkesen F, Evcen R, et al. Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency. J Med Palliat Care / JOMPAC / jompac. 2026;7(1):133-139. doi:10.47582/jompac.1861792

Chicago

Kılınç, Mehmet, Fatih Çölkesen, Recep Evcen, et al. 2026. “Implications of Baseline IgG4-to-IgG Ratios for Autoimmune Manifestations in Common Variable Immunodeficiency”. Journal of Medicine and Palliative Care 7 (1): 133-39. https://doi.org/10.47582/jompac.1861792.

EndNote

Kılınç M, Çölkesen F, Evcen R, Sadi Aykan F, Yıldız E, Önalan T, Akkuş FA, Arslan Ş (February 1, 2026) Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency. Journal of Medicine and Palliative Care 7 1 133–139.

IEEE

[1]M. Kılınç et al., “Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 1, pp. 133–139, Feb. 2026, doi: 10.47582/jompac.1861792.

ISNAD

Kılınç, Mehmet - Çölkesen, Fatih - Evcen, Recep - Sadi Aykan, Filiz - Yıldız, Eray - Önalan, Tuğba - Akkuş, Fatma Arzu - Arslan, Şevket. “Implications of Baseline IgG4-to-IgG Ratios for Autoimmune Manifestations in Common Variable Immunodeficiency”. Journal of Medicine and Palliative Care 7/1 (February 1, 2026): 133-139. https://doi.org/10.47582/jompac.1861792.

JAMA

1.Kılınç M, Çölkesen F, Evcen R, Sadi Aykan F, Yıldız E, Önalan T, Akkuş FA, Arslan Ş. Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency. J Med Palliat Care / JOMPAC / jompac. 2026;7:133–139.

MLA

Kılınç, Mehmet, et al. “Implications of Baseline IgG4-to-IgG Ratios for Autoimmune Manifestations in Common Variable Immunodeficiency”. Journal of Medicine and Palliative Care, vol. 7, no. 1, Feb. 2026, pp. 133-9, doi:10.47582/jompac.1861792.

Vancouver

1.Mehmet Kılınç, Fatih Çölkesen, Recep Evcen, Filiz Sadi Aykan, Eray Yıldız, Tuğba Önalan, Fatma Arzu Akkuş, Şevket Arslan. Implications of baseline IgG4-to-IgG ratios for autoimmune manifestations in common variable immunodeficiency. J Med Palliat Care / JOMPAC / jompac. 2026 Feb. 1;7(1):133-9. doi:10.47582/jompac.1861792