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Serum IgG4: A New Biomarker for Mesothelioma Pleural Effusion

Serum IgG4: A New Biomarker for Mesothelioma Pleural Effusion

Egyptian scientists say a new biomarker is very good at identifying mesothelioma. Pleural effusions are pockets of excess fluid. They collect around the lungs of people with certain kinds of cancer and other conditions.

Biomarkers in pleural effusions are proteins and other substances found in mesothelioma patients. The new study suggests that using this biomarker the right way can lead to more accurate diagnoses.

The Importance of Biomarkers in Pleural Effusions

Pleural mesothelioma is a rare cancer of the lung lining. It is a challenge to diagnose. The early symptoms can be as vague as cough and fatigue. But an accurate diagnosis is often the difference between life and death.

As tumors grow, mesothelioma patients produce pleural effusions or ‘water on the lungs.’ This is a byproduct of the body’s attempt to fight disease. This fluid buildup is very common with pleural mesothelioma. But not all people with pleural effusions have mesothelioma.

Pleural effusion is caused by immunoglobulin G4 (IgG4). Tumor biomarkers such as carcinoembryonic antigen (CEA) may have a role in the diagnosis of malignant pleural effusion. Dr. Ahmed Metwally and his team from Assuit University were able to confirm that IgG4 can help. It has good diagnostic accuracy for pleural effusions in patients with malignant mesothelioma.

The study published in the Egyptian Journal of Bronchology included 89 patients. Nine (10.10%) of these patients had malignant mesothelioma.

IgG4 was observed in patients with malignant mesothelioma. And the serum level of CEA was significantly higher among patients with malignant mesothelioma. This is good news for the hunt for a biomarker for mesothelioma pleural effusion.

Identifying Mesothelioma 

A biomarker for mesothelioma pleural effusion can help doctors identify mesothelioma. If pathologists know what they are looking for, tests of the fluid may point strongly toward or away from malignant mesothelioma.

Serum IgG4 has been shown to have good diagnostic accuracy and it can help in diagnosing malignant pleural effusion. Pleural mesothelioma accounts for 4 out of 5 mesothelioma cases. In the US, that amounts to about 2,000 people every year. This new biomarker could lead to early diagnosis of malignant mesothelioma.


El-Sokkary, Raafat T., Nermen M. Abuelkassem, Mohamed Ismail Seddik, and Ahmed Metwally. “New biomarkers for the diagnosis of pleural effusion.” The Egyptian Journal of Bronchology 16, no. 1 (2022): 1-9. https://link.springer.com/article/10.1186/s43168-022-00137-7

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