IHC Marker - IgG4 Test: Booking, Price, and Results
About IHC Marker - IgG4 Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | IgG4 Immunostain Test, Immunohistochemistry IgG4 Test, IgG4 IHC Stain Test, IgG4 Tissue Marker Test |
| Sample Type | Formalin-fixed, paraffin-embedded (FFPE) tissue block |
| Fasting Required | Not required |
| Report Time | 3 days |
| Recommended For | All genders and ages; primarily middle-aged to older adults with suspected IgG4-related disease |
| Price | Starting at ₹1,920 |
What Is an IHC Marker - IgG4 Test?
The IHC marker - IgG4 test is a specialised tissue analysis that identifies IgG4-positive plasma cells (a type of immune cell) in a biopsy sample. It is prescribed when a doctor suspects IgG4-related disease (IgG4-RD), an autoimmune condition that can cause inflammation and scarring across multiple organs. The test uses immunohistochemistry (IHC), a laboratory method that applies targeted antibodies to stained tissue sections. It is also known as the IgG4 immunostain test, immunohistochemistry IgG4 test, IgG4 IHC stain test, or IgG4 tissue marker test.
What Does an IHC Marker - IgG4 Test Measure?
The IHC marker - IgG4 test procedure examines stained tissue sections under a microscope. The following parameters are assessed:
| Parameter | What It Shows |
|---|---|
| IgG4-positive plasma cells | Number of IgG4-bearing immune cells per high-power field (HPF) in the tissue |
| IgG4/IgG plasma cell ratio | The proportion of IgG4-positive cells out of all IgG-positive cells in the sample |
IgG4 is the least abundant subclass of immunoglobulin G, normally making up about 6% of total IgG. When found in unusually high numbers in tissue, it points towards IgG4-related disease.
Why Is an IHC Marker - IgG4 Test Done?
A doctor may recommend this test when the clinical picture points to IgG4-related disease but a confirmed diagnosis requires tissue evidence.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to order the IHC marker - IgG4 test:
- Unexplained enlargement or swelling of an organ
- Painless, tumour-like masses in the abdomen, chest, or other sites
- Jaundice (yellowing of the skin and eyes)
- Abdominal pain, particularly in the upper region
- Eye swelling or proptosis (bulging of the eye)
- Difficulty swallowing
- Unexplained weight loss
Conditions This Test Can Help Detect
This test helps identify a range of IgG4-related conditions, including:
- Type 1 autoimmune pancreatitis
- Mikulicz disease and sclerosing sialadenitis (inflammation of the salivary glands)
- Inflammatory orbital pseudotumour (a mass-like lesion in and around the eye socket)
- Chronic sclerosing aortitis (inflammation of the main artery)
- Riedel thyroiditis and a subset of Hashimoto thyroiditis
- IgG4-related interstitial pneumonitis (lung inflammation)
- IgG4-related tubulointerstitial nephritis (kidney inflammation)
- Pemphigus vulgaris and pemphigus foliaceus (blistering skin conditions, when frozen tissue is unavailable)
IHC Marker - IgG4 Test for Chronic Disease Monitoring
This test may be repeated to assess disease activity, treatment response, or relapse in patients with confirmed IgG4-related disease. Most patients show a response to glucocorticoid therapy within 2 to 4 weeks, though treatment is usually continued for at least 3 to 6 months. Relapses are common, and the test helps doctors decide whether further treatment is needed.
How to Prepare and What to Expect
Preparation for this test differs from routine blood tests because a tissue sample, not blood, is required. Your treating doctor or surgeon will guide you through the biopsy process.
Do You Need to Fast?
No fasting is required for this test. The sample is a tissue biopsy, not a blood draw, so dietary restrictions do not apply. Your doctor may, however, have separate fasting instructions if sedation or anaesthesia is needed for the biopsy procedure itself.
Practical Tips Before Your Test
Keep the following in mind before your biopsy appointment:
- Bring a detailed clinical history including your symptoms, previous test results, and any relevant imaging studies, as this is required for the test
- Inform your doctor about all current medications, especially steroids or immunosuppressants, as these can affect IgG4 cell counts in tissue
- Share any prior imaging reports (CT or MRI scans) so the biopsy site can be selected accurately
- Ask your doctor whether there are any specific pre-procedure instructions related to sedation or anaesthesia, if applicable
Step-by-Step Procedure
- A surgeon or specialist performs a biopsy, removing a small piece of tissue from the affected organ, such as the pancreas, salivary gland, kidney, or eye socket.
- The tissue is fixed in 10% neutral buffered formalin for 24 to 48 hours to preserve it, then processed and embedded in a paraffin block (an FFPE block).
- The laboratory cuts thin sections (5 microns thick) from the paraffin block and prepares at least two slides per antibody for staining.
- The IgG4 immunohistochemistry staining is performed using a monoclonal antibody and a horseradish peroxidase polymer technique on an automated immunostainer.
- A trained pathologist examines the stained slides under a microscope, counts IgG4-positive plasma cells per high-power field, and calculates the IgG4/IgG ratio.
- The pathologist prepares a written report, which is delivered within 3 days of the laboratory receiving the sample.
Factors That Can Affect Accuracy
The following factors may influence the reliability of the IHC marker - IgG4 test:
- Use of fixatives other than 10% neutral buffered formalin, which may yield unsatisfactory staining results
- Inadequate tissue fixation time or insufficient sample size
- Tissue crush or handling artefacts introduced during the biopsy
- Current use of steroids or immunosuppressant medications
- Biopsy taken from a predominantly fibrotic (scarred) area with few remaining cells
Understanding Your IHC Marker - IgG4 Test Results
Results from the IHC marker - IgG4 test must always be reviewed alongside clinical findings, imaging, and other laboratory results. The table below lists the generally accepted thresholds used in diagnosis:
| Parameter | Suggestive Threshold for IgG4-RD |
|---|---|
| IgG4+ plasma cells (biopsy specimen) | More than 10 cells per HPF |
| IgG4+ plasma cells (resection or larger specimen) | More than 30 to 50 cells per HPF |
| IgG4/IgG plasma cell ratio | More than 40% |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Elevated IgG4-positive plasma cells are not exclusive to IgG4-related disease. They can also appear in Castleman disease, nodular-sclerosing Hodgkin lymphoma, and other inflammatory or infectious conditions. Because higher IgG4 cell counts are common in Hodgkin lymphoma, pathologists also check for Reed-Sternberg cells to rule out this diagnosis. All IHC results must be interpreted alongside the full clinical and histopathological picture.
How to Maintain Healthy Levels
Lifestyle changes do not directly influence IgG4 cell levels in tissue. However, the following steps support overall health for those diagnosed with IgG4-related disease:
- Early diagnosis and prompt treatment can help prevent permanent organ scarring (fibrosis).
- Regular follow-up with a rheumatologist or relevant organ specialist is advisable for those already diagnosed.
- Attending all scheduled reviews and repeat investigations helps detect relapses early.
Lupin Diagnostics IHC Marker - IgG4 Test Price
The IHC Marker - IgG4 test cost at Lupin Diagnostics starts at ₹1,920. This test requires a visit to a hospital for a biopsy sample; home collection is not available for this test. The table shows city-wise prices across major cities:
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 1920 |
| CHENNAI | 1920 |
| HYDERABAD | 1920 |
| KOLKATA | 1920 |
| NAVI MUMBAI | 1920 |
| PUNE | 1920 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book the IHC marker - IgG4 test online booking through Lupin Diagnostics:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample submission or coordinate with your treating hospital for tissue dispatch.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The IHC marker - IgG4 test is used to detect IgG4-positive plasma cells in tissue samples from patients with suspected autoimmune or inflammatory conditions. It is the key diagnostic tool for confirming IgG4-related disease (IgG4-RD), which can affect multiple organs, including the pancreas, kidneys, and salivary glands.
The sample is a tissue biopsy obtained by a surgeon or specialist from the affected organ, such as the pancreas, salivary gland, kidney, or eye socket. The tissue is then fixed in formalin and embedded in a paraffin block before being sent to the laboratory. This procedure is performed in a clinical or hospital setting.
No. This test requires a tissue biopsy, which must be performed by a trained medical professional in a clinical or hospital setting. IHC marker - IgG4 test home collection option is not available.
At Lupin Diagnostics, the report delivery time is 3 days. Your test results are delivered directly through email or WhatsApp.
IgG4-related disease can affect virtually any organ. The most commonly involved sites include the pancreas, kidneys, salivary glands, the tissues around the eyes, and the retroperitoneum (the area behind the abdominal cavity).
Yes. Elevated IgG4-positive plasma cells can occur in conditions other than IgG4-related disease, including nodular-sclerosing Hodgkin lymphoma and Castleman disease. This is why results must always be interpreted alongside clinical history, imaging findings, and other histopathological features.
Yes. The IHC marker - IgG4 test may be repeated to assess how well a patient is responding to treatment or to check for disease relapse. Since IgG4-related disease can recur even after successful treatment, periodic evaluation with a specialist is recommended.
IHC Marker - IgG4 Test: Booking, Price, and Results
