Autoinflammatory & rare systemic diseases
Fractional exhaled nitric oxide is a non-invasive disease activity marker of IgG4-related disease
Authors' conclusion
FeNO value was elevated in patients with IgG4-RD and was associated with disease activity. Moreover, it can be associated with lung involvement.
Study context
- Population
- Patients with IgG4-related disease (IgG4-RD) fulfilling the 2019 ACR/EULAR classification criteria who had never received oral GC21 males
- Participants
- 35 patients
- Exposure
- High Fractional Exhaled Nitric Oxide (FeNO) vs low FeNO
- High FeNOn = 23
- Outcome
- FeNO value as a non-invasive disease activity marker (association with clinical parameters and IgG4-RI)
Methodological detailsglucocorticoid-naive patients, Spearman's rank correlation, ROC analysis
- Glucocorticoid-naive patients
- Spearman's rank correlation
- ROC analysis
Main finding
As reported in the abstract
FeNO value
- Median FeNO, ppb (IQR 33.0, 99.5)
- 48.0
- Patients exceeding cutoff, n (%)
- 23 (65.7%)
- Correlation of FeNO with serum IgG4 levels (r = 0.48)
- P = 0.020
- Correlation of FeNO with number of organ involvements (r = 0.47)
- P = 0.020
- Correlation of FeNO with IgG4-RI (r = 0.47)
- P = 0.020
Observational data: associations, not effects.
Further findings
Lung involvement by FeNO group
P = 0.029
FeNO for identifying lung involvement (ROC)
- AUC
- 0.88
- Optimal cutoff (Youden index), ppb
- 55.2
Original publication
Fractional exhaled nitric oxide is a non-invasive disease activity marker of IgG4-related disease. Rheumatology (Oxford). Published 21 August 2026. doi:10.
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