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The impact of elevated serum IgG4 levels in patients with primary sclerosing cholangitis
Authors:Maria Benito de Valle  Tobias Müller  Einar Björnsson  Morgane Otten  Martin Volkmann  Olaf Guckelberger  Bertram Wiedenmann  Riadh Sadik  Eckart Schott  Mats Andersson  Thomas Berg  Björn Lindkvist
Institution: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;g Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden;h Gastroenterology and Reumatology Clinic, Hepatology Section, University Hospital Leipzig, Germany
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.
Keywords:IgG4 status  Prevalence  Survival
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