Serial Changes of Elevated Serum IgG4 Levels in IgG4-related Systemic Disease
Open Access
- 1 January 2011
- journal article
- Published by Japanese Society of Internal Medicine in Internal Medicine
- Vol. 50 (2), 69-75
- https://doi.org/10.2169/internalmedicine.50.4321
Abstract
Objective Autoimmune pancreatitis (AIP) and Mikulicz's disease have recently been recognized as pancreatic or salivary gland lesions of IgG4-related systemic disease. These are frequently associated with elevated serum IgG4 levels. This study aimed to clarify clinical implications of serial changes of elevated serum IgG4 levels in IgG4-related systemic diseases. Methods Serial changes of elevated serum IgG4 levels were examined in patients with IgG4-related systemic diseases. Patients Serial changes of elevated serum IgG4 levels were examined in 44 patients: AIP (n=24), Mikulicz's disease (n=8), pancreatic cancer (n=5), bile duct cancer (n=1), sclerosing cholangitis (n=1), hypereosinophilic syndrome (n=1), chronic thyroiditis (n=1), hypophysitis (n=1), idiopathic pancreatitis (n=1), and Behcet's disease (n=1). Results The serum IgG4 levels decreased in all patients with AIP and Mikulicz's disease after steroid therapy. The serum IgG4 levels were normalized in 46% of AIP patients and 38% of Mikulicz's disease patients. The serum IgG4 levels were not normalized at remission in 3 of 4 relapsed AIP patients, and re-elevation of serum IgG4 levels was detected in all relapsed patients. Elevated serum IgG4 levels decreased in 3 patients with pancreatic cancer after resection or chemotherapy, and decreased in patients with hypereosinophilic syndrome, sclerosing cholangitis, and hypophysitis after steroid therapy. Conclusion Measurement of serial serum IgG4 levels is useful to determine the disease activity of IgG4-related systemic diseases.Keywords
This publication has 22 references indexed in Scilit:
- Japanese consensus guidelines for management of autoimmune pancreatitis: III. Treatment and prognosis of AIPThe Esophagus, 2010
- Serum IgG4 concentrations and IgG4-related sclerosing diseaseClinica Chimica Acta; International Journal of Clinical Chemistry, 2009
- Standard steroid treatment for autoimmune pancreatitisGut, 2009
- Recent advances in autoimmune pancreatitisGut, 2009
- Sclerosing cholangitis associated with autoimmune pancreatitis differs from primary sclerosing cholangitisWorld Journal of Gastroenterology, 2009
- Asian diagnostic criteria for autoimmune pancreatitis: consensus of the Japan-Korea Symposium on Autoimmune PancreatitisThe Esophagus, 2008
- Th2 and regulatory immune reactions are increased in immunoglobin G4-related sclerosing pancreatitis and cholangitisHepatology, 2007
- Autoimmune pancreatitis: proposal of IgG4-related sclerosing diseaseThe Esophagus, 2006
- A new clinicopathological entity of IgG4-related autoimmune diseaseThe Esophagus, 2003
- Regulation of the development of type 2 T-helper cells in allergyCurrent Opinion in Immunology, 1994