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Clinical and pathological differences between serum immunoglobulin G4-positive and -negative type 1 autoimmune pancreatitis

查看全文 作　　者：Woo Hyun [1]Paik;Ji Kon [1,2]Ryu;Jin Myung [1]Park;Byeong Jun [1]Song;Joo Kyung [1]Park;Yong-Tae [1]Kim;Kyoungbun [3]Lee 高影响力作者 机构地区：[1]Department of Internal Medicine, Liver Research Institute;[2]Division of Gastroenterology, Department of Internal Medicine, Seoul National University College of Medicine;[3]Department of Pathology, Seoul National University College of Medicine高影响力机构 出　　处：《World Journal of Gastroenterology》索引2013年第19卷第25期,共8页高影响力期刊 摘　　要：AIM: To identify clinical and pathological differences between serum immunoglobulin G4 (IgG4)-positive (SIP) and IgG4-negative (SIN) type 1 autoimmune pancreatitis (AIP) in South Korea. METHODS: AIP was diagnosed by the international consensus diagnostic criteria. The medical records and pathology were retrospectively reviewed and IgG4-positive cells were counted in a high power field (HPF). Type I AIP was defined as a high serum level of IgG4or histological finding. SIN type 1 AIP was defined as a histological evidence of type 1 AIP and a normal serum IgG4 level. The clinical and pathological findings were compared between the two groups. The analysis was performed using Student's t test, Fischer's exact test and Mann-Whitney's U test. A P value of < 0.05 was considered statistically significant. As repeated com- parison was made, P values of less than 5% (P < 0.05) were considered significant. RESULTS: Twenty five patients with definite type 1 AIP (19 histologically and six serologically diagnosed cases) were enrolled. The mean tissue IgG4 concentrations were significantly higher in SIP than SIN group (40 cells per HPF vs 18 cells per HPF, P = 0.02). Among eight SIN patients, the tissue IgG4 concentrations were less than 15 cells per HPF in most of cases, except one. The sensitivity of serum IgG4 was 68% (17 SIP and eight SIN AIP). Other organ involvement was more frequent- ly associated with SIP than SIN AIP (59% vs 26%, P = 0.016). However, the relapse rate and diffuse swelling of the pancreas were not associated with serum IgG4 level. The concentrations of IgG4-positive cells per HPF were higher in SIP than SIN AIP (40 vs 18, P = 0.02). CONCLUSION: The sensitivity of serum IgG4 was 68% in type 1 AIP. High serum IgG4 level was associated with other organ involvement and tissue IgG4 concentration but did not affect the relapse rate in type 1 AIP. 关 键 词：AUTOIMMUNITY Chronic PANCREATITIS IMMUNOGLOBULIN G4-related systemic disease Lymphoplas-macytic SCLEROSING PANCREATITIS IMMUNOGLOBULIN G4
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