揭开血清阴性自身免疫性胰腺炎的神秘面纱。

Demystifying seronegative autoimmune pancreatitis.

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic 200 First Street SW, Rochester, Minnesota 55905, USA.

出版信息

Pancreatology. 2012 Jul-Aug;12(4):289-94. doi: 10.1016/j.pan.2012.05.003. Epub 2012 May 11.

DOI:10.1016/j.pan.2012.05.003

PMID:22898628

Abstract

BACKGROUND

Autoimmune pancreatitis (AIP) has been classified into type 1 and type 2 subtypes. Serum immunoglobulin G4 (IgG4) elevation characterizes type 1 AIP. Type 2 AIP and a subset of type 1 AIP are seronegative, i.e., have normal serum IgG4 levels.

AIM

We compared the profiles of the three subsets of AIP to identify the unique characteristics of seronegative type 1 AIP and type 2 AIP.

METHODS

We compared the clinical profiles of 69 seropositive type 1 AIP patients, 21 seronegative type 1 AIP patients and 22 type 2 AIP patients.

RESULTS

Among type 1 AIP, seronegative group had similar clinical profiles when compared to seropositive group except that they were more likely to undergo surgical resection than seropositive patients (p = 0.001). Seronegative type I AIP patients were older (61.9 ± 13.7 vs 45.3 ± 17.4; p = 0.004), and differed in the occurrence of other organ involvement (OOI) (71.4% vs 0%; p < 0.001) and disease relapse (33.3% vs 0%; p = 0.005) when compared with type 2 AIP. All seronegative type 1 AIP patients had at least one of the following -OOI, disease relapse, and age >50 years while none of the type 2 AIP had OOI or disease relapse.

CONCLUSIONS

Seronegative and seropositive type 1 AIP patients have similar clinical profiles, which are distinct from that of type 2 AIP. Among the seronegative AIP group, patients are more likely to have type 1 AIP rather than type 2 AIP if they are older than 50 years or have OOI or disease relapse.

摘要

背景

自身免疫性胰腺炎（AIP）已分为 1 型和 2 型亚型。血清免疫球蛋白 G4（IgG4）升高是 1 型 AIP 的特征。2 型 AIP 和部分 1 型 AIP 为血清阴性，即 IgG4 水平正常。

目的

我们比较了 AIP 的三个亚组的特征，以确定血清阴性 1 型 AIP 和 2 型 AIP 的独特特征。

方法

我们比较了 69 例血清阳性 1 型 AIP 患者、21 例血清阴性 1 型 AIP 患者和 22 例 2 型 AIP 患者的临床特征。

结果

在 1 型 AIP 中，血清阴性组与血清阳性组的临床特征相似，但与血清阳性患者相比，他们更有可能接受手术切除（p=0.001）。血清阴性 1 型 AIP 患者年龄较大（61.9±13.7 岁 vs 45.3±17.4 岁；p=0.004），且发生其他器官受累（OOI）（71.4% vs 0%；p<0.001）和疾病复发（33.3% vs 0%；p=0.005）的情况也不同。与 2 型 AIP 相比，所有血清阴性 1 型 AIP 患者至少有一种-OOI、疾病复发和年龄>50 岁，而没有 2 型 AIP 患者有 OOI 或疾病复发。