{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:56:43Z","timestamp":1760122603647,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2016,10,2]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>IgG4 disease is rare. However, IgG4 tubulointerstitial nephritis (TIN) is the most common renal manifestation. IgG4 disease is usually associated with elevated serum IgG4 levels and other organ involvement, low-density renal lesions on enhanced CT imaging and immune activation. The incidence of IgG4-TIN may be underestimated, as staining for IgG4 is not routine. This study sought to describe the prevalence of previously undiagnosed IgG4-TIN. Due to the complexity of the diagnosis, we only attempt to look at IgG4-positive plasma cell TIN as a potential indication for IgG4 renal disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective review of native renal biopsies performed between 2002 and 2012 with a primary diagnosis of TIN was selected. Samples for which interstitial nephritis was secondary to a glomerular disease were excluded. The tissues were stained for IgG4 and scored by two blinded observers. Demographic and follow-up details were collected. This study was approved by the local ethics committee.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>82 cases of interstitial nephritis from a total of 1238 renal biopsies (2002\u20132012) were available after staining for further assessment. 12 samples demonstrated staining consistent with the criteria for IgG4-positive plasma cell TIN, of which 3 had mildly positive staining, 7 moderately positive staining and 2 had markedly positive staining. There were no statistically significant differences in the baseline characteristics between the positive and negative staining groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A number of cases of IgG4-positive plasma cell TIN were observed histologically that had been previously diagnosed as non-specific chronic TIN. IgG4-positive plasma cell TIN made up 1% of all renal biopsies performed over 10\u2005years and 13% of all biopsies demonstrating TIN not related to glomerular disease. IgG4 staining should be considered routinely in biopsies demonstrating primary TIN.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jclinpath-2016-203905","type":"journal-article","created":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T23:14:27Z","timestamp":1476832467000},"page":"483-487","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["The incidence of IgG4-positive plasma cells staining TIN in patients with biopsy-proven tubulointerstitial nephritis"],"prefix":"10.1136","volume":"70","author":[{"given":"Kathy","family":"Mac","sequence":"first","affiliation":[{"name":"Renal Unit, Liverpool Hospital, Liverpool, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao Juan","family":"Wu","sequence":"additional","affiliation":[{"name":"Anatomical Pathology Department, Liverpool Hospital, Liverpool, NSW, Australia"},{"name":"University of Western Sydney, Campbelltown, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Mai","sequence":"additional","affiliation":[{"name":"Renal Unit, Liverpool Hospital, Liverpool, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Howlin","sequence":"additional","affiliation":[{"name":"Renal Unit, Liverpool Hospital, Liverpool, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Suranyi","sequence":"additional","affiliation":[{"name":"Renal Unit, Liverpool Hospital, Liverpool, NSW, Australia"},{"name":"University of Western Sydney, Campbelltown, NSW, Australia"},{"name":"University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Yong","sequence":"additional","affiliation":[{"name":"Anatomical Pathology Department, Liverpool Hospital, Liverpool, NSW, Australia"},{"name":"University of Western Sydney, Campbelltown, NSW, Australia"},{"name":"University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Makris","sequence":"additional","affiliation":[{"name":"Renal Unit, Liverpool Hospital, Liverpool, NSW, Australia"},{"name":"University of Western Sydney, Campbelltown, NSW, Australia"},{"name":"University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,10,18]]},"reference":[{"key":"2025092503563442000_70.6.483.1","first-page":"128","article-title":"IgG4-related autoimmune diseases: polymorphous presentation complicates diagnosis and treatment","volume":"112","author":"Kleger","year":"2015","journal-title":"Dtsch Arztebl Int"},{"key":"2025092503563442000_70.6.483.2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02232341"},{"key":"2025092503563442000_70.6.483.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.27435"},{"key":"2025092503563442000_70.6.483.4","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2012.72"},{"key":"2025092503563442000_70.6.483.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-011-0521-2"},{"key":"2025092503563442000_70.6.483.6","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2006.10.025"},{"key":"2025092503563442000_70.6.483.7","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318059b87c"},{"key":"2025092503563442000_70.6.483.8","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.393"},{"key":"2025092503563442000_70.6.483.9","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3787"},{"key":"2025092503563442000_70.6.483.10","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.271"},{"key":"2025092503563442000_70.6.483.11","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1002\/art.38193","article-title":"Brief report: spuriously low serum IgG4 concentrations caused by the prozone phenomenon in patients with IgG4-related disease","volume":"66","author":"Khosroshahi","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2025092503563442000_70.6.483.12","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2011010062"},{"key":"2025092503563442000_70.6.483.13","first-page":"609795","article-title":"Immunohistochemical characteristics of IgG4-related tubulointerstitial nephritis: detailed analysis of 20 Japanese cases","volume":"2012","author":"Kawano","year":"2012","journal-title":"Int J Rheumatol"},{"key":"2025092503563442000_70.6.483.14","first-page":"565","article-title":"IgG4-related disease: a systemic condition with characteristic microscopic features","volume":"28","author":"Detlefsen","year":"2013","journal-title":"Histol Histopathol"},{"key":"2025092503563442000_70.6.483.15","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.342"},{"key":"2025092503563442000_70.6.483.16","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-011-0589-2"},{"key":"2025092503563442000_70.6.483.17","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328341a240"},{"key":"2025092503563442000_70.6.483.18","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2012.07.004"},{"key":"2025092503563442000_70.6.483.19","doi-asserted-by":"publisher","DOI":"10.1080\/00313029400169032"},{"key":"2025092503563442000_70.6.483.20","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2011.101"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2016-203905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T10:56:43Z","timestamp":1758797803000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2016-203905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,18]]},"references-count":20,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2017,5,22]]},"published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1136\/jclinpath-2016-203905"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2016-203905","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[2016,10,18]]}}}