Serum IgG4 concentrations and IgG4-related sclerosing disease

Tabata, Taku; Kamisawa, Terumi; Takuma, Kensuke; Anjiki, Hajime; Egawa, Naoto; Kurata, Masahiro; Honda, G.; Tsuruta, Kouji; Setoguchi, Keigo; Obayashi, Taminori; Sasaki, Tsuneo

doi:10.1016/j.cca.2009.06.036

Cited by 75 publications

(57 citation statements)

References 24 publications

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“…Recent studies reported that serum IgG4 concentration has a sensitivity of 77% and specificity of 90% for diagnosing AIP, which is much lower than previously estimated [3, 21,22]. In another study of type I AIP, elevated serum IgG4 concentrations were found in 80% of patients [23].…”

Section: Igg4 Detectionmentioning

confidence: 45%

“…Although 4%-7% of patients with pancreatic cancer have an elevated serum IgG4 concentration [22,42], a serum IgG4 concentration of >280 mg dL 1 is highly suggestive of AIP but not pancreatic cancer [23]. A diffuse plasma cell infiltrate with >30 IgG4-positive cells per high-power field and a ratio of IgG4 to total IgG of >50%, together with the characteristic histopathological findings, supports a diagnosis of AIP.…”

Section: Differential Diagnosismentioning

confidence: 90%

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Autoimmune pancreatitis: current concepts

Wang

Zhang

2013

Sci. China Life Sci.

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Autoimmune pancreatitis (AIP) is a distinct type of chronic pancreatitis with unique clinical, pathological, serological, and imaging features. AIP usually presents with obstructive jaundice. Imaging studies often reveal enlargement of the pancreas with a pancreatic mass and strictures of the main pancreatic duct. Two subtypes of AIP have recently been identified. Type I AIP is more prevalent in elderly Asian males and is characterized by lymphoplasmacytic sclerosing pancreatitis, obliterative phlebitis, and infiltration of large numbers of IgG4-positive plasma cells. Type II AIP is more prevalent in Caucasians and is characterized by granulocyte epithelial lesions. Most patients with type I AIP have a significantly elevated serum IgG4 concentration, which is an important feature for diagnosis and for differentiating between AIP and other conditions such as pancreatic cancer. Extrapancreatic complications are common, such as sclerosing cholangitis, sclerosing sialadenitis, retroperitoneal fibrosis in type I AIP, and ulcerative colitis in type II AIP. A rapid response to glucocorticoids treatment is suggestive of AIP, but the relapse rate is high, warranting the use of immunosuppressant treatment. B-cell depletion with rituximab may be a promising therapy. The prognosis of AIP is generally benign if treated promptly, and spontaneous remission occurs in a proportion of patients. autoimmune pancreatitis, IgG4, pancreatic cancer, glucocorticoids Citation:

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Section: Igg4 Detectionmentioning

confidence: 45%

Section: Differential Diagnosismentioning

confidence: 90%

Autoimmune pancreatitis: current concepts

Wang

Zhang

2013

Sci. China Life Sci.

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“…Ze względu na wielonarządowy charakter AIP, skłon-ność do włóknienia oraz obecność w badaniach im munohistochemicznych limfocytów T i plazmocytów wytwarzających immunoglobulinę podklasy IgG 4 zaproponowano dla tej choroby nazwę "ogólnoustrojowa choroba stwardnieniowa zależna od IgG 4 " [11][12][13]. Ostatnie badania wskazują jednak, że kliniczny i immunologiczny obraz AIP nie jest jednorodny.…”

Section: Wstępunclassified

Autoimmune pancreatitis as a systemic, protracted and potentially fatal disease

Pasierbek-Kohutek¹,

Gutkowski²,

Barczyk³

et al. 2013

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“…At this point, we considered that the patient did not have SS but most probably Mikulicz's disease (MD)/IgG4-positive multiorgan lymphoproliferative syndrome (IgG4+ MOLPS) based on the exceptionally elevated IgG4 levels 1 . As this patient only had mild complaints of xerophthalmia with no major organ involvement at this time, no immunosuppressive therapy was indicated.…”

Section: Just Another Case Of Sjögren's Syndrome?mentioning

confidence: 99%

“…In SS patients serum IgG4 is not elevated and no infiltration of IgG4-positive plasmacytes is observed 4 . High serum IgG4 concentrations have also been found in a small number of pathological conditions, such as autoimmune pancreatitis, atopic dermatitis, pemphigus vulgaris, and even interstitial nephritis 1,5,6 . Therefore, recent reports proposed a new clinical entity called the IgG4+ MOLPS for the above mentioned diseases including MD 7 .…”

Section: Just Another Case Of Sjögren's Syndrome?mentioning

confidence: 99%