American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a significant indicator of treatment effectiveness in IgG4-related disease?

1. Reduction in symptoms only

2. Decrease in fibrosis

3. Improvement in blood pressure

4. Normalization of liver function tests

The correct answer is: Decrease in fibrosis

In IgG4-related disease, a significant indicator of treatment effectiveness is the decrease in fibrosis. This condition is characterized by not just the presence of inflammation, but also by the development of fibrous tissue in the affected organs. Therefore, successful treatment is often reflected in the reduction of fibrosis, which can have substantial implications for the patient's overall health and function of the involved organs. While reduction in symptoms is important, it does not fully capture the underlying pathophysiology of the disease. Similarly, improvement in blood pressure or normalization of liver function tests may indicate concurrent issues but do not specifically address the hallmark aspects of IgG4-related disease, particularly the fibrotic changes resulting from the condition. Thus, measuring the decrease in fibrosis provides a clearer, more objective indication of how well the treatment is working in managing the disease and its complications.