Maria Benito de Valle1, Tobias Müller2, Einar Björnsson3, Morgane Otten4, Martin Volkmann5, Olaf Guckelberger6, Bertram Wiedenmann2, Riadh Sadik1, Eckart Schott2, Mats Andersson7, Thomas Berg8, Björn Lindkvist9. 1. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden. 2. Institute of Medicine, Hepatology and Gastroenterology, University Hospital Charité, Campus Virchow Clinic, Berlin, Germany. 3. Department of Internal Medicine, Section of Gastroenterology and Hepatology, The National University Hospital, Reykjavik, Iceland. 4. Occupational Health Centrum, University Hospital The Charité, Campus Virchow Clinic, Berlin, Germany. 5. MVZ Labor Prof. Seelig, Karlsruhe, Germany. 6. General and Transplantation Surgery Clinic, University Hospital The Charité, Campus Virchow Clinic, Berlin, Germany. 7. Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden. 8. Gastroenterology and Reumatology Clinic, Hepatology Section, University Hospital Leipzig, Germany. 9. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: bjorn.lindkvist@vgregion.se.
Abstract
BACKGROUND: Elevated IgG4 levels have been reported among patients with primary sclerosing cholangitis. Epidemiological data has only been provided from tertiary centres. AIMS: To investigate the prevalence of elevated IgG4 levels and to compare prognosis between patients with and without elevated IgG4 levels in serum in two European cohorts of patients with primary sclerosing cholangitis. METHODS: Serum IgG4-levels were measured in a consecutive series of patients from Berlin, and retrospectively collected in a population-based cohort from Sweden (total N=345). Cox's proportional hazard analysis was used to calculate relative risks for liver-related death or liver transplantation and cholangiocarcinoma. RESULTS: Elevated IgG4 values were demonstrated in 10% of patients. A previous history of pancreatitis, combined intra- and extrahepatic biliary involvement and jaundice were independently associated with elevated IgG4 in multivariate analysis. IgG4 status was not associated with an increased risk for the combined endpoint liver-related death or liver transplantation or cholangiocarcinoma. CONCLUSION: The prevalence of elevated IgG4 values among European patients with primary sclerosing cholangitis is similar to what previously has been reported from the United States. Elevated IgG4 was not associated with an increased risk of liver transplantation or liver-related death or cholangiocarcinoma.
BACKGROUND: Elevated IgG4 levels have been reported among patients with primary sclerosing cholangitis. Epidemiological data has only been provided from tertiary centres. AIMS: To investigate the prevalence of elevated IgG4 levels and to compare prognosis between patients with and without elevated IgG4 levels in serum in two European cohorts of patients with primary sclerosing cholangitis. METHODS: Serum IgG4-levels were measured in a consecutive series of patients from Berlin, and retrospectively collected in a population-based cohort from Sweden (total N=345). Cox's proportional hazard analysis was used to calculate relative risks for liver-related death or liver transplantation and cholangiocarcinoma. RESULTS: Elevated IgG4 values were demonstrated in 10% of patients. A previous history of pancreatitis, combined intra- and extrahepatic biliary involvement and jaundice were independently associated with elevated IgG4 in multivariate analysis. IgG4 status was not associated with an increased risk for the combined endpoint liver-related death or liver transplantation or cholangiocarcinoma. CONCLUSION: The prevalence of elevated IgG4 values among European patients with primary sclerosing cholangitis is similar to what previously has been reported from the United States. Elevated IgG4 was not associated with an increased risk of liver transplantation or liver-related death or cholangiocarcinoma.
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