A new clinicopathological entity of IgG4-related autoimmune disease

J Gastroenterol. 2003;38(10):982-4. doi: 10.1007/s00535-003-1175-y.

Abstract

Background: Autoimmune pancreatitis (AIP) is occasionally associated with other autoimmune diseases.

Methods: To investigate the pathophysiology of AIP, we immunohistochemically examined the pancreas and other organs in eight patients with AIP, and in controls, using anti-CD4-T and CD8-T cell subsets, as well as IgG4 antibodies.

Results: In AIP patients, severe or moderate infiltration of IgG4-positive plasma cells associated with CD4- or CD8-positive T lymphocytes was detected in the peripancreatic tissue (6/6), bile duct (8/8), gallbladder (8/8), portal area of the liver (3/3), gastric mucosa (5/7), colonic mucosa (2/2), salivary glands (1/2), lymph nodes (6/6), and bone marrow (2/2), as well as in the pancreas (8/8). There were few IgG4-positive plasma cells at the same sites in controls.

Conclusions: These results suggest that AIP is not simply pancreatitis but that it is a pancreatic lesion involved in IgG4-related systemic disease with extensive organ involvement. We propose a new clinicopathological entity, of a systemic IgG4-related autoimmune disease in which AIP and its associated diseases might be involved. Autoimmune pancreatitis (AIP) is occasionally associated with other autoimmune diseases.

MeSH terms

  • Aged
  • Antigens, Differentiation, B-Lymphocyte / blood
  • Antigens, Differentiation, B-Lymphocyte / immunology
  • Antigens, Differentiation, T-Lymphocyte / blood
  • Antigens, Differentiation, T-Lymphocyte / immunology
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / physiopathology*
  • Bile Ducts / immunology
  • Bile Ducts / metabolism
  • Bile Ducts / pathology
  • Biomarkers / blood
  • Chronic Disease
  • Colon / immunology
  • Colon / metabolism
  • Colon / pathology
  • Female
  • Gastric Mucosa / metabolism
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology*
  • Immunohistochemistry
  • Liver / immunology
  • Liver / metabolism
  • Liver / pathology
  • Lymph Nodes / immunology
  • Lymph Nodes / metabolism
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Pancreatitis / blood
  • Pancreatitis / immunology
  • Pancreatitis / physiopathology
  • Plasma Cells / immunology
  • Plasma Cells / metabolism
  • Retroperitoneal Fibrosis / blood
  • Retroperitoneal Fibrosis / immunology
  • Retroperitoneal Fibrosis / physiopathology
  • Salivary Glands / immunology
  • Salivary Glands / metabolism
  • Salivary Glands / pathology
  • Severity of Illness Index
  • Statistics as Topic
  • Stomach / immunology
  • Stomach / pathology

Substances

  • Antigens, Differentiation, B-Lymphocyte
  • Antigens, Differentiation, T-Lymphocyte
  • Biomarkers
  • Immunoglobulin G