Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Clin Gastroenterol Hepatol. 2012 Jan;10(1):79-83. doi: 10.1016/j.cgh.2011.09.015. Epub 2011 Oct 1.
BACKGROUND & AIMS: High serum levels of immunoglobulin (Ig)E often are detected in patients with primary sclerosing cholangitis (PSC), but the clinical significance is not known.
We analyzed data from 44 patients with PSC and known serum levels of IgE. They were divided into groups called high IgE (>170 IU/mL; n = 17) or normal IgE (n = 27). We compared occurrence of biliary carcinoma including cholangiocellular and gallbladder carcinoma, liver transplantation, and death between groups.
The high IgE group had a later age of onset of PSC than the normal IgE group (54 ± 20 y vs 39 ± 16 y; P = .010); they also had a higher serum level of IgG (2078 ± 638 vs 1517 ± 475 mg/dL; P = .002) and IgG4 (104 ± 102 vs 38 ± 16 mg/dL; P = .002). Association with inflammatory bowel disease did not differ significantly between groups (5 of 17 vs 11 of 27; P = .661). No patient had biliary carcinoma in the high IgE group, but biliary carcinoma was observed during the follow-up period in 8 patients in the normal IgE group (0 of 17 vs 8 of 27; P = .016). The occurrence of biliary carcinoma, liver transplantation, or death did not differ between groups (4 of 17 vs 13 of 27; P = .124).
High serum levels of IgE often are observed in older patients with PSC and are associated with a reduced incidence of biliary carcinoma.
原发性硬化性胆管炎（PSC）患者常检测到免疫球蛋白（Ig）E 血清水平升高，但临床意义尚不清楚。
我们分析了 44 例已知 IgE 血清水平的 PSC 患者的数据。他们分为高 IgE 组（>170 IU/mL；n = 17）或正常 IgE 组（n = 27）。我们比较了两组之间胆管癌（包括胆管细胞癌和胆囊癌）、肝移植和死亡的发生情况。
高 IgE 组 PSC 的发病年龄晚于正常 IgE 组（54 ± 20 岁 vs 39 ± 16 岁；P =.010）；他们的 IgG（2078 ± 638 比 1517 ± 475 mg/dL；P =.002）和 IgG4（104 ± 102 比 38 ± 16 mg/dL；P =.002）血清水平也更高。两组之间与炎症性肠病的关联无显著差异（17 例中有 5 例 vs 27 例中有 11 例；P =.661）。高 IgE 组无一例发生胆管癌，但在正常 IgE 组中，8 例患者在随访期间发生胆管癌（0 例 vs 27 例中的 8 例；P =.016）。两组之间胆管癌、肝移植或死亡的发生没有差异（17 例中有 4 例 vs 27 例中有 13 例；P =.124）。
PSC 老年患者常出现高血清 IgE 水平，与胆管癌发病率降低有关。
