TITLE

Antibodies to carbonic anhydrase and IgG4 levels in idiopathic chronic pancreatitis: relevance cor diagnosis of autoimmune pancreatitis

AUTHOR(S)
Aparisi, L.; Farre, A.; Gomez-Cambronero, L.; Martinez, J.; De Las Heras, G.; Corts, J.; Navarro, S.; Mora, J.; Lopez-Hoyos, M.; Sabater, L.; Ferrandez, A.; Bautista, D.; Perez-Mateo, M.; Mery, S.; Sastre, J.
PUB. DATE
May 2005
SOURCE
Gut;May2005, Vol. 54 Issue 5, p703
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Increased serum antibodies against carbonic anhydrase II (CA-II Ab) or IgG4 levels have been reported in cases of autoimmune chronic pancreatitis (ACP). Aim: To assess the relevance of serum CA-Il Ab and lgG4 levels for the diagnosis of ACP in idiopathic CP (ICP) versus alcoholic CP and Sjögren's syndrome (SS). Subjects: This was a multicentre study involving 227 subjects divided into four groups: ICP (n = 54), normal controls (n = 54, paired by age and sex with ICP patients), alcoholic CP (n = 86), and SS (n = 33). Methods: CA-II Ab was measured by ELISA and confirmed by western blotting. A score of easy clinical use with major clinical, morphological, and biochemical parameters for the diagnosis of ACP was applied. Results: The percentage of patients with increased serum CA-II Ab was higher in the ICP group (28%) than in controls (1.9%) and in patients with alcoholic CP (10.5%), but lower than in patients with SS (64%). The proportion with elevated IgG4 levels was higher in the ICP group (15%) compared with controls (1.9%) and SS (0%) but not significantly different from alcoholic CP (8%). Most ICP patients (7/8) with high lgG4 levels exhibited increased CA-II Ab and a compatible ACP score. A definitive diagnosis of ACP by histological analysis was associated with other autoimmune disorders, an increase in both serum lgG4 and CA-II Ab levels, and IgG4 positive plasma cells. Conclusions: The increase in serum 1gG4 levels was strongly associated with elevated CA-II Ab levels, manifestations compatible with ACP, and lymphoplasmacytic infiltration when surgical specimens were available.
ACCESSION #
16886348

 

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