Higher serum IgG4 levels correlate with better quality of life in mild Graves' orbitopathy: a preliminary report.
Journal
Endocrine connections
Journal Volume
15
Journal Issue
1
Start Page
Article number e250582
ISSN
2049-3614
Date Issued
2026-01-01
Author(s)
Lee, Yi-Chieh
Hsiue, Yen-Chung
Yang, Chung-Yi
Lee, Chung-Wei
Lu, Ching
Huang, Tse-Ying
Lin, Chun-Hsien
Abstract
Background: Graves’ orbitopathy (GO) profoundly affects patients’ quality of life, even in its mild form, yet the underlying factors contributing to this impairment remain underexplored. Recent evidence suggests the potential immune tolerance-inducing effect of immunoglobulin G4 (IgG4) in the pathogenesis of GO. However, its specific impact on quality of life and its significance in mild GO have not been well characterized. Methods: This prospective multicenter study included patients with mild GO who were in euthyroidism. Quality of life was assessed using the validated GO-quality of life questionnaire (GO-QoL). Serum IgG4 levels and IgG4/IgG ratios were measured and analyzed in relation to GO-QoL scores and other clinical and biochemical parameters. Results: Patients with mild GO exhibited significantly impaired quality of life, with the greatest impact seen in the appearance subscale. Notably, serum IgG4 levels were positively correlated with visual functioning scores in the GO-QoL (ρ = 0.248, P = 0.0466). Higher serum IgG4 levels were also associated with less limitation in driving and a longer duration of GO. Moreover, serum IgG4 levels and IgG4/IgG ratios showed significant positive correlations with male sex and clinical activity score. Conclusions: This study highlights the significant impairment in the quality of life experienced by patientswithmild GO and identifies serum IgG4 as a promising indicator for evaluating disease chronicity and quality of life, which may help guide different treatment strategies. Further prospective and basic studies are required to explore the role of IgG4 in the pathogenesis of GO.
Subjects
Graves’ orbitopathy
immunoglobulin G4
quality of life
thyroid eye disease
Type
journal article