Characteristics of autoimmune pancreatitis based on serum IgG4 level.

Abstract

BACKGROUND:

Autoimmune pancreatitis is categorized as an IgG4-related autoimmune disease, mostly associated with serological alterations, however characteristics of autoimmune pancreatitis based on serum markers have not been fully evaluated.

METHODS:

We evaluated demographics, symptoms, imaging and therapeutic outcome in 27 cases of autoimmune pancreatitis stratified by serum IgG4 level.

RESULTS:

Twenty patients (74%) had elevated serum IgG4 and 7 (26%) had normal IgG4 levels. Compared to patients with normal serum IgG4 levels, patients with elevated IgG4 had higher incidence of jaundice at onset (14.3% vs. 80%, respectively; P=0.002), more frequent diffuse pancreatic enlargement at imaging (14.3% vs. 60%, respectively; P=0.04), significantly higher 18F-2-fluoro-2-deoxy-d-glucose uptake of pancreatic lesions (SUV max: 4.0 vs. 5.7, respectively; P=0.02), more frequent extrapancreatic lesions (42.9% vs. 85%, respectively; P=0.03). Response to steroids was recognized regardless of serum IgG4 level, however maintenance therapy was required more frequently amongst patients with elevated compared to normal IgG4 (85.7% vs. 33.3%, respectively; P=0.04).

CONCLUSIONS:

Clinical features of autoimmune pancreatitis are different based on level of serum IgG4. Further studies are needed to clarify if normal serum IgG4 cases are a precursor of active type 1 or type 2 autoimmune pancreatitis.

• Authors: Hiroyuki Matsubayashi, Hiroaki Sawai, Hirokazu Kimura, Yuichiro Yamaguchi, Masaki Tanaka, Naomi Kakushima, Kohei Takizawa, Maho Kadooka, Toshitatsu Takao, Sachin Hebbar, Hiroyuki Ono
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 43 Issue 9 Pg. 731-5 (Sep 2011) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 21515099 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Autoantibodies
• Biomarkers
• Immunoglobulin A
• Immunoglobulin G
• Immunoglobulin M
• Fluorodeoxyglucose F18
• Prednisolone

Topics

• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Autoantibodies (blood)
• Autoimmune Diseases (diagnosis, immunology)
• Biomarkers (blood)
• Chi-Square Distribution
• Female
• Fluorodeoxyglucose F18
• Humans
• Immunoglobulin A (blood)
• Immunoglobulin G (blood)
• Immunoglobulin M (blood)
• Jaundice (etiology)
• Male
• Middle Aged
• Multidetector Computed Tomography
• Pancreatitis (diagnosis, diagnostic imaging, drug therapy, immunology)
• Positron-Emission Tomography
• Prednisolone (therapeutic use)
• Recurrence
• Statistics, Nonparametric
• Ultrasonography