Department of Gastroenterology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
World J Gastroenterol. 2010 Nov 7;16(41):5241-6. doi: 10.3748/wjg.v16.i41.5241.
To clarify the clinical significance of high serum IgE in autoimmune pancreatitis (AIP).
Forty-two AIP patients, whose IgE was measured before steroid treatment, were analyzed. To evaluate the relationship between IgE levels and the disease activity of AIP, we examined (1) Frequency of high IgE (> 170 IU/mL) and concomitant allergic diseases requiring treatment; (2) Correlations between IgG, IgG4, and IgE; (3) Relationship between the presence of extrapancreatic lesions and IgE; (4) Relationship between clinical relapse and IgE in patients treated with steroids, and (5) Transition of IgE before and after steroid treatment.
IgE was elevated in 36/42 (86%) patients. Concomitant allergic disease was observed in seven patients (allergic rhinitis in three, bronchial asthma in three, and urticaria in one). There were no significant correlations between IgG, IgG4, and IgE (r = -0.168 for IgG, and r = -0.188 for IgG4). There was no significant difference in IgE in the patients with and without extrapancreatic lesions (526 ± 531 IU/mL vs 819 ± 768 IU/mL, P = 0.163), with and without clinical relapse (457 ± 346 IU/mL vs 784 ± 786 IU/mL, P = 0.374). There was no significant difference in IgE between before and after steroid treatment (723 ± 744 IU/mL vs 673 ± 660 IU/mL, P = 0.633).
Although IgE does not necessarily reflect the disease activity, IgE might be useful for the diagnosis of AIP in an inactive stage.
阐明自身免疫性胰腺炎（AIP）患者血清 IgE 升高的临床意义。
分析了 42 例在类固醇治疗前检测 IgE 的 AIP 患者。为了评估 IgE 水平与 AIP 疾病活动之间的关系，我们检查了：（1）高 IgE（>170 IU/mL）的发生率和需要治疗的伴随过敏性疾病；（2）IgG、IgG4 和 IgE 之间的相关性；（3）胰外病变与 IgE 的关系；（4）接受类固醇治疗的患者临床复发与 IgE 的关系；（5）类固醇治疗前后 IgE 的变化。
42 例患者中有 36 例（86%）IgE 升高。7 例患者伴有过敏性疾病（3 例变应性鼻炎，3 例支气管哮喘，1 例荨麻疹）。IgG、IgG4 与 IgE 之间无显著相关性（r=-0.168 用于 IgG，r=-0.188 用于 IgG4）。有胰外病变和无胰外病变的患者之间的 IgE 无显著差异（526±531 IU/mL vs 819±768 IU/mL，P=0.163），有临床复发和无临床复发的患者之间的 IgE 也无显著差异（457±346 IU/mL vs 784±786 IU/mL，P=0.374）。类固醇治疗前后的 IgE 无显著差异（723±744 IU/mL vs 673±660 IU/mL，P=0.633）。
尽管 IgE 不一定反映疾病活动度，但 IgE 可能有助于诊断处于不活跃阶段的 AIP。
