Kang Pung, Lee Kyu Taek, Sinn Dong Hyunn, Kim Beom Jin, Lee Jae Seung, Lee Jong Kyun, Rhee Jong Chul
Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Korean J Gastroenterol. 2008 Nov;52(5):304-9.
BACKGROUND/AIMS: To diagnose autoimmune pancreatitis (AIP), serum IgG and IgG4 concentration are significant serologic markers. The purpose of this study was to assess the utility of serum IgG and IgG4 for the diagnosis of AIP.
We divided enrolled patients into 2 groups: autoimmune pancreatitis and other pancreatic disease. We measured serum IgG and IgG4 levels in patients including 12 AIP and 23 other pancreatic disease.
Among AIP patients, 10 cases (83%) showed elevated IgG4 levels of more than 135 mg/dL and 4 cases (33%) showed elevated IgG levels of more than 1,800 mg/dL, the current cutoff value applied in Japan. Only one patient showed elevated serum IgG level, despite having normal IgG4 level. Sensitivity and specificity for AIP of elevated serum IgG4 (>135 mg/dL) were 91% and 92%, and for elevated serum IgG (>1,800 mg/dL) 67% and 92%, respectively. The optimal cut-off level of IgG4 using receiver operation characteristic (ROC) was 127 mg/dL, at which the sensitivity and specificity were 83% and 96%, respectively, for the diagnosis of AIP. Serum IgG at 1,520 mg/dL showed the sensitivity and specificity of 83% and 87%, respectively.
The measurement of serum IgG and IgG4 are helpful to diagnose AIP. Serum IgG and IgG4 are complementary to each other in the diagnosis of AIP.
背景/目的：血清IgG和IgG4浓度是诊断自身免疫性胰腺炎（AIP）的重要血清学标志物。本研究旨在评估血清IgG和IgG4在AIP诊断中的应用价值。
我们将纳入的患者分为两组：自身免疫性胰腺炎组和其他胰腺疾病组。我们检测了包括12例AIP患者和23例其他胰腺疾病患者的血清IgG和IgG4水平。
在AIP患者中，10例（83%）的IgG4水平升高超过135mg/dL，4例（33%）的IgG水平升高超过1800mg/dL，这是日本目前应用的临界值。仅有1例患者尽管IgG4水平正常，但IgG水平升高。血清IgG4升高（>135mg/dL）对AIP的敏感性和特异性分别为91%和92%，血清IgG升高（>1800mg/dL）对AIP的敏感性和特异性分别为67%和92%。使用受试者工作特征曲线（ROC）确定的IgG4最佳临界水平为127mg/dL，此时诊断AIP的敏感性和特异性分别为83%和96%。血清IgG水平为1520mg/dL时，敏感性和特异性分别为83%和87%。
检测血清IgG和IgG4有助于诊断AIP。血清IgG和IgG4在AIP诊断中相互补充。
