BOJKOVÁ, Martina, Petr DÍTĚ, Jana DVOŘÁČKOVÁ, Ivo NOVOTNÝ, Katarína FLOREÁNOVÁ, Bohuslav KIANIČKA, Magdalena UVÍROVÁ and Arnošt MARTÍNEK. Immunoglobulin G4, Autoimmune Pancreatitis and Pancreatic Cancer. Digestive Diseases. Basel: Karger, 2015, vol. 33, No 1, p. 86-90. ISSN 0257-2753. Available from: https://dx.doi.org/10.1159/000368337.
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Basic information
Original name Immunoglobulin G4, Autoimmune Pancreatitis and Pancreatic Cancer
Authors BOJKOVÁ, Martina (203 Czech Republic), Petr DÍTĚ (203 Czech Republic), Jana DVOŘÁČKOVÁ (203 Czech Republic), Ivo NOVOTNÝ (203 Czech Republic), Katarína FLOREÁNOVÁ (203 Czech Republic, belonging to the institution), Bohuslav KIANIČKA (203 Czech Republic, guarantor, belonging to the institution), Magdalena UVÍROVÁ (203 Czech Republic) and Arnošt MARTÍNEK (203 Czech Republic).
Edition Digestive Diseases, Basel, Karger, 2015, 0257-2753.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher Switzerland
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.777
RIV identification code RIV/00216224:14110/15:00082328
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1159/000368337
UT WoS 000346891600011
Keywords in English Immunoglobulin G4; Autoimmune pancreatitis; Pancreatic cancer
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 9/7/2015 13:52.
Abstract
Background: Immunoglobulin G4 (IgG4)-related diseases are a group of diseases characterized by enlargement of the affected organs, elevation of serum IgG4, massive infiltration of affected organs with lymphocytes and plasma cells with IgG4 positivity and tissue fibrosis. Type I autoinnmune pancreatitis is one form of IgG4-related disease. For IgG4-related diseases, various localizations are described for up to 10% of malignancies. The aim of our study was to examine IgG4 serum levels and pancreatic tissue with respect to the simultaneous presence of autoimmune pancreatitis in patients with pancreatic cancer. Methods: IgG4 serum levels were examined In 106 patients with histologically confirmed pancreatic cancer. The level of 135 mg/dl was considered as the normal value. Pancreatic tissue was histologically examined with respect to the presence of markers of autoimmune pancreatitis. Results: A higher IgG4 level than the cut-off value of 135 mg/dl was proven in 11 patients with pancreatic cancer. Of these 11 patients, 7 had levels twice the normal limit (65.6%). Autoimmune pancreatitis was diagnosed in these individuals. In the case of 1 patient, it was basically an unexpected finding; another patient was initially diagnosed with autoimmune pancreatitis. Repeated biopsy of the pancreas at the time of diagnosis did not confirm the presence of tumour structures, therefore steroid therapy was started. At a check-up 6 months after starting steroid therapy, the condition of the patient improved subjectively and IgG4 levels decreased. However, endosonographically, malignancy was suspected, which was subsequently confirmed histologically. This patient also demonstrated an IgG4 level twice the normal limit. Conclusion: IgG4-related diseases can be accompanied by the simultaneous occurrence of malignancies, which also applies to autoimmune pancreatitis. Chronic pancreatitis is considered a risk factor for pancreatic cancer. It cannot be reliably confirmed whether this also applies to autoimmune pancreatitis. In accordance with other works, however, it is evident that, despite the described high sensitivity and specificity for IgG4 elevation in the case of autoimmune pancreatitis, even levels twice the normal limit are demonstrable in some individuals with pancreatic cancer, without the presence of autoimmune pancreatitis. We believe that patients with IgG4-related disease, including autoimmune pancreatitis, must be systematically monitored with respect to the potential presence of malignancy. (C) 2014 S. Karger AG, Basel
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