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Titre du Document
Elevated serum IgG4 concentration in patients with primary sclerosing cholangitis
Auteur(s)
MENDES Flavia D. ; JORGENSEN Roberta ; KEACH Jill ; ...
Résumé
OBJECTIVES: Biliary strictures, similar to primary sclerosing cholangitis (PSC), have been reported in patients with autoimmune pancreatitis, which is characterized by elevated serum lgG4 levels and responsiveness to corticosteroids. We sought to determine the frequency of elevated lgG4 in patients with PSC and to clinically compare PSC patients with elevated and normal lgG4 levels. METHODS: We measured serum lgG4 in 127 patients with PSC and 87 patients with primary biliary cirrhosis, as disease controls. Demographic, clinical, and laboratory characteristics were compared between the PSC groups with normal and elevated lgG4 (>140 mg/dL). RESULTS: Elevated lgG4 was found in 12 PSC patients (9%) versus one PBC patient (1.1%) (p = 0.017). Patients with elevated lgG4 had higher total bilirubin (p = 0.009), alkaline phosphatase (p = 0.01), and PSC Mayo risk score (p = 0.038), and lower frequency of IBD (p < 0.0001). Importantly, the time to liver transplantation was shorter in patients with elevated lgG4 (1.7 vs 6.5 yr, p = 0.0009). The type of biliary involvement (intrahepatic, extrahepatic, or both) and pancreatic involvement were similar in both groups. CONCLUSIONS: A small proportion of PSC patients had elevated serum lgG4. In these patients parameters of liver disease severity were more pronounced and time to liver transplantation was shorter, suggesting a more severe disease course. It is possible that this subset of patients behaves similarly to autoimmune pancreatitis pat
Editeur
Blackwell Publishing
Identifiant
PMID : 16879434 ISSN : 0002-9270
Source
The American journal of gastroenterology A. 2006, vol. 101, n° 9, pp. 2070-2075 [6 pages] [bibl. : 19 ref.]
Langue
Anglais
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