The prevalence of IgG4-positive plasma cell infiltrates in inflammatory bowel disease patients without autoimmune pancreatitis

Topal, Firdevs; E, Sarıtaş Yüksel; Ekinci, Nurcan Unver Ozgur; Pekdiker, Mete; Çakalağaoğlu, Fulya; Alper, Emily C.; Ünsal, Belkıs

doi:10.5152/tjg.2014.5714

Cited by 16 publications

(22 citation statements)

References 17 publications

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“…These differences may result from an excessive infiltration of plasma cells, particularly IgG4-expressing plasma cells, in the inflamed intestinal mucosa in a subset of patients with IBD. Another issue to be noted is that the upper limit of normal (ULN) of serum IgG4 in our study (1.5 g/L) was higher than the values defined in other studies (range, 1.12–1.40 g/L) due to different laboratory methods 17 , 19 , 25 . Most previous studies focused on the infiltration of mucosal IgG4 cells in IBD, and only a small number of patients were examined for serum IgG4.…”

Section: Discussioncontrasting

confidence: 81%

High level of IgG4 as a biomarker for a new subset of inflammatory bowel disease

Zhu

Luo

et al. 2018

Sci Rep

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The roles of B and plasma cells in the pathogenesis of inflammatory bowel disease (IBD) are largely unrevealed. Data on the characteristics of IgG4 in patients with IBD are scarce. In this case-control study, serum IgG4 levels were comparable between patients with IBD and healthy individuals, whereas patients with IBD had dramatically higher mucosal IgG4 counts than healthy individuals. In patients with UC, mucosal IgG4 counts were positively correlated with serum IgG4 levels, serum IgG4/IgG ratios, and the Mayo Index; serum IgG4 levels and IgG4/IgG ratios were associated with a history of intestinal surgery and medications. A significant mucosal IgG4 count was found in 33.3% of patients with IBD, whereas, elevated serum IgG4 levels were found in only 9.9% of patients with IBD. Lesions were more severe and extensive in IBD patients with high levels of serum and mucosal IgG4. High levels of serum and mucosal IgG4 decreased after treatment with glucocorticoids or other immunosuppressants. High IgG4 level may be a biomarker for a new subset of IBD. More studies are warranted to explore this new subset of IBD for personalized therapy in the future.

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Section: Discussioncontrasting

confidence: 81%

High level of IgG4 as a biomarker for a new subset of inflammatory bowel disease

Zhu

Luo

et al. 2018

Sci Rep

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“…Comments: Only single clinical observations 100–102 and small series (groups) 102‐105 of patients are presented. Topal et al 105 detected IgG4‐positive plasma cell staining in the colon biopsies of 21 out of 119 (17.6%) patients with inflammatory bowel disease without AIP. Of these 21 patients, five displayed elevated serum IgG4 levels (>140 mg/dl).…”

Section: Introduction and Methodologymentioning

confidence: 99%

“…For the bowel, only single case reports are available, and the histological criteria are rarely reported. Also, serum IgG4 is rarely reported/increased for the bowel 105 , 108 . Most cases are mainly based on increased IgG4‐positive cells, 100 , 105 , 107–109 often without reported IgG4/IgG ratios 107 , 108 .…”

Section: Introduction and Methodologymentioning

confidence: 99%

“…Distinction between reactive changes due to AIP and/or IRC and primary hepatic manifestations of IgG4-relate disease is often difficult. Comments: Only single clinical observations 100-102 and small series (groups) [102][103][104][105] of patients are presented. Topal et al 105 detected IgG4-positive plasma cell staining in the colon biopsies of 21 out of 119 (17.6%) patients with inflammatory bowel disease without AIP.…”

Section: Q22: What Are the Imaging Features Of Aip? Statement 22mentioning

confidence: 99%

“…Also, serum IgG4 is rarely reported/increased for the bowel. 105,108 Most cases are mainly based on increased IgG4-positive cells, 100,105,[107][108][109] often without reported IgG4/IgG ratios. 107,108 Thus, there remains major uncertainty regarding organ involvement of the esophagus, stomach, and intestine in IgG4-related disease.…”

Section: Q22: What Are the Imaging Features Of Aip? Statement 22mentioning

confidence: 99%

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European Guideline on IgG4‐related digestive disease – UEG and SGF evidence‐based recommendations

et al. 2020

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The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6–0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2–4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added.

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Gastrointestinal manifestation of immunoglobulin G4-related disease: clarification through a multicenter survey

et al. 2017

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The prevalence of IgG4-positive plasma cell infiltrates in inflammatory bowel disease patients without autoimmune pancreatitis

Abstract: In our study, 4.2% of patients with the diagnosis of IBD had elevated IgG4 serum levels and significant IGg4 immunostaining. Together, these two parameters indicate the possible diagnosis of an IgG4-related systemic disease.

Cited by 16 publications

References 17 publications

High level of IgG4 as a biomarker for a new subset of inflammatory bowel disease

High level of IgG4 as a biomarker for a new subset of inflammatory bowel disease

European Guideline on IgG4‐related digestive disease – UEG and SGF evidence‐based recommendations

Gastrointestinal manifestation of immunoglobulin G4-related disease: clarification through a multicenter survey

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