About IgG4-Related Disease
IgG4-related disease was recognized as a unified clinical entity only in 2003, when Japanese researchers linked autoimmune pancreatitis to a systemic condition with IgG4-positive tissue infiltration in multiple organs. The pathophysiology involves aberrant T follicular helper cells driving IgG4 class switching in B cells, CD4+ cytotoxic T lymphocytes that infiltrate tissues and produce profibrotic cytokines, and activated fibroblasts that deposit collagen in a characteristic whorled (storiform) pattern.
Diagnosis requires tissue biopsy in most cases, with histopathological criteria including dense lymphoplasmacytic infiltrate, storiform fibrosis, and obliterative phlebitis. Serum IgG4 levels are elevated in about 60 to 70% of patients but are neither sensitive nor specific enough for diagnosis alone. PET-CT is increasingly used to map organ involvement and monitor treatment response.
In April 2025, inebilizumab (Uplizna), a monoclonal antibody targeting CD19-positive B cells, became the first FDA-approved treatment for IgG4-related disease. In the Phase 3 MITIGATE trial, inebilizumab dramatically reduced flares, with only 10% of treated patients experiencing a flare versus 60% on placebo. Prior to this approval, treatment relied on glucocorticoids (effective but associated with 24 to 63% relapse rates upon tapering) and off-label rituximab.
Common Symptoms of IgG4-Related Disease
Recognizing the signs of IgG4-Related Disease early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Painless swelling of salivary or lacrimal (tear) glands
- Pancreas inflammation that can mimic pancreatic cancer on imaging
- Kidney dysfunction from tubulointerstitial nephritis
- Retroperitoneal fibrosis causing back pain and ureteral obstruction
- Sclerosing cholangitis (bile duct narrowing) causing jaundice
- Lymph node enlargement, lung nodules, or aortitis depending on organ involvement
Who IgG4-Related Disease Affects
Predominantly affects adults aged 50 to 70 years. Sex distribution varies by organ involvement: pancreatobiliary and retroperitoneal disease is more common in men, while salivary and lacrimal gland disease has a more equal or female-predominant distribution. Overall U.S. data shows a slight female majority.
Affects all ethnicities. Diagnosis is frequently delayed because the condition mimics cancer, lymphoma, or other autoimmune diseases.
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FDA-Approved Treatments for IgG4-Related Disease
There is currently 1 FDA-approved medication for IgG4-Related Disease. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.
Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.
Help Paying for IgG4-Related Disease Treatment
Charity funds and drugmaker programs for IgG4-Related Disease, checked at the source. Pick your insurance to see what fits.
- From a charity · NORD RareCareIgG4-RD Medical Assistance fundOpen
Pays for: Medical and medication costs.
The foundation says: “Accepting Applications” - From a charity · NORD RareCareIgG4-RD Premium Copay Assistance fundOpen
Pays for: Insurance premiums and copays.
The foundation says: “Accepting Applications” - From a charity · The Assistance FundImmunoglobulin G4-Related Disease (IgG4-RD) fundOpen
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “OPEN — Accepting New Patients. TAF is currently accepting new patient enrollments for this program.”
Side Effect Explorer
Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.
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Genetic Testing
Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.
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Trusted IgG4-Related Disease Resources
Reputable organizations and medical references for learning more about IgG4-Related Disease, including disease registries, foundation resources, and clinical guidelines.
