2020 RCD Criteria (IgG4-Related Disease)

Applies the 2020 revised comprehensive diagnostic criteria for IgG4-related disease.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Characteristic organ swelling, mass or nodule
Yes
Serum IgG4, mg/dL
300
Dense lymphoplasmacytic infiltration with fibrosis
Yes
IgG4+/IgG+ ratio above 40 percent and over 10 per HPF
Yes

Result: Definite IgG4-related disease

The tool opens with these values already filled in. Replace them with your own.

What the result means

Definite
Items 1 + 2 + 3: characteristic organ involvement, an elevated serum IgG4, and the pathological item.
Probable
Items 1 + 3: characteristic organ involvement and the pathological item, without an elevated serum IgG4.
Possible
Items 1 + 2: organ involvement and a raised serum IgG4, with NO tissue. The weakest category, not a mild form of the disease.
Item 1
One or more organs showing diffuse or localized swelling, a mass or a nodule. Where a single organ is involved, lymph node swelling does not count.
Item 3
TWO of three: dense lymphoplasmacytic infiltration with fibrosis; IgG4+/IgG+ ratio above 40 percent with over 10 cells per HPF; storiform fibrosis or obliterative phlebitis.
What 2020 changed
The pathological item. Two of three, with storiform fibrosis or obliterative phlebitis as a third route, so a biopsy with poor immunostaining can still carry it.
Why possible is weak
Serum IgG4 also rises in malignancy, infection and other autoimmune disease, which is exactly where a mimic would sit.

What you enter

  • Characteristic organ swelling, mass or nodule
  • Lymph node swelling only, single organ
  • Serum IgG4, mg/dL
  • Dense lymphoplasmacytic infiltration with fibrosis
  • IgG4+/IgG+ ratio above 40 percent and over 10 per HPF
  • Storiform fibrosis or obliterative phlebitis
How this is calculated

Umehara H, Okazaki K, Kawa S, et al. The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD. Mod Rheumatol. 2021;31(3):529-533. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.