自身免疫性胰腺炎与系统性自身免疫性疾病的关联。
Association between autoimmune pancreatitis and systemic autoimmune diseases.
机构信息
First Department of Medicine, University of Szeged, H-6701 Szeged, Hungary.
出版信息
World J Gastroenterol. 2012 Jun 7;18(21):2649-53. doi: 10.3748/wjg.v18.i21.2649.
AIM
To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4).
METHODS
The serum level of IgG4 was measured in 61 patients with SAIDs of different types who had not yet participated in glucocorticosteroid treatment. Patients with an elevated IgG4 level were examined by abdominal ultrasonography (US) and, in some cases, by computer tomography (CT).
RESULTS
Elevated serum IgG4 levels (919 ± 996 mg/L) were detected in 17 (28%) of the 61 SAID patients. 10 patients had Sjögren's syndrome (SS) (IgG4: 590 ± 232 mg/L), 2 of them in association with Hashimoto's thyroiditis, and 7 patients (IgG4: 1388 ± 985.5 mg/L) had systemic lupus erythematosus (SLE). The IgG4 level in the SLE patients and that in patients with SS were not significantly different from that in AIP patients (783 ± 522 mg/L). Abdominal US and CT did not reveal any characteristic features of AIP among the SAID patients with an elevated IgG4 level.
CONCLUSION
The serum IgG4 level may be elevated in SAIDs without the presence of AIP. The determination of serum IgG4 does not seem to be suitable for the differentiation between IgG4-related diseases and SAIDs.
目的
通过测量血清免疫球蛋白 G4（IgG4）来研究自身免疫性胰腺炎（AIP）与系统性自身免疫性疾病（SAIDs）之间的关联。
方法
在 61 名不同类型的尚未接受糖皮质激素治疗的 SAIDs 患者中测量了血清 IgG4 水平。对 IgG4 水平升高的患者进行腹部超声（US）检查，在某些情况下进行计算机断层扫描（CT）检查。
结果
在 61 名 SAID 患者中，有 17 名（28%）患者血清 IgG4 水平升高（919 ± 996 mg/L）。10 名患者患有干燥综合征（SS）（IgG4：590 ± 232 mg/L），其中 2 名伴有桥本甲状腺炎，7 名患者患有系统性红斑狼疮（SLE）（IgG4：1388 ± 985.5 mg/L）。SLE 患者和 SS 患者的 IgG4 水平与 AIP 患者的 IgG4 水平无显著差异（783 ± 522 mg/L）。在 IgG4 水平升高的 SAID 患者中，腹部 US 和 CT 均未显示出 AIP 的任何特征性表现。
结论
SAIDs 患者的血清 IgG4 水平可能升高，而不存在 AIP。血清 IgG4 的测定似乎不适用于区分 IgG4 相关疾病和 SAIDs。
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