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溃疡性结肠炎与免疫球蛋白 G4

Ulcerative colitis and immunoglobulin G4.

机构信息

Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.

Department of Endoscopy, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.

出版信息

Gut Liver. 2014 Jan;8(1):29-34. doi: 10.5009/gnl.2014.8.1.29. Epub 2013 Nov 5.

DOI:10.5009/gnl.2014.8.1.29
PMID:24516698
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3916684/
Abstract

BACKGROUND/AIMS: Ulcerative colitis (UC) is sometimes associated with autoimmune pancreatitis (AIP). Infiltration of immunoglobulin G4 (IgG4)-positive plasma cells is sometimes detected in the colonic mucosa of AIP or UC patients. This study aimed to clarify the relation between UC and IgG4.

METHODS

Associations with UC were reviewed in 85 AIP patients. IgG4 immunostaining was performed on biopsy specimens from the colonic mucosa of 14 AIP and 32 UC patients.

RESULTS

UC was confirmed in two cases (type 1 AIP, n=1; suspected type 2 AIP, n=1). Abundant infiltration of IgG4-positive plasma cells in the colonic mucosa was detected in the case of suspected type 2 AIP with UC and two cases of type 1 AIP without colitis. Abundant infiltration of IgG4-positive plasma cells was detected in 10 UC cases (IgG4-present, 31%). Although 72% of IgG4-absent UC patients showed mild disease activity, 70% of IgG4-present patients showed moderate to severe disease activity (p<0.05).

CONCLUSIONS

UC is sometimes associated with AIP, but it seems that UC is not a manifestation of IgG4-related disease. Infiltration of IgG4-positive plasma cells is sometimes detectable in the colonic mucosa of UC patients and is associated with disease activity.

摘要

背景/目的:溃疡性结肠炎(UC)有时与自身免疫性胰腺炎(AIP)相关。在 AIP 或 UC 患者的结肠黏膜中有时会检测到 IgG4 阳性浆细胞浸润。本研究旨在阐明 UC 与 IgG4 的关系。

方法

回顾了 85 例 AIP 患者的 UC 关联。对 14 例 AIP 和 32 例 UC 患者的结肠黏膜活检标本进行 IgG4 免疫染色。

结果

在合并 UC 的 2 例(1 例为 1 型 AIP,1 例为疑似 2 型 AIP)中得到证实。在伴有 UC 的疑似 2 型 AIP 和 2 例无结肠炎的 1 型 AIP 病例中,结肠黏膜中 IgG4 阳性浆细胞大量浸润。在 10 例 UC 病例中(IgG4 阳性,31%)检测到 IgG4 阳性浆细胞大量浸润。虽然 72%的 IgG4 阴性 UC 患者表现为轻度疾病活动,但 70%的 IgG4 阳性患者表现为中度至重度疾病活动(p<0.05)。

结论

UC 有时与 AIP 相关,但 UC 似乎不是 IgG4 相关疾病的表现。在 UC 患者的结肠黏膜中有时会检测到 IgG4 阳性浆细胞浸润,并与疾病活动相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c02a/3916684/1c4b9e860ff0/gnl-8-29-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c02a/3916684/778ea0615a9e/gnl-8-29-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c02a/3916684/1c4b9e860ff0/gnl-8-29-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c02a/3916684/778ea0615a9e/gnl-8-29-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c02a/3916684/1c4b9e860ff0/gnl-8-29-g002.jpg

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本文引用的文献

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J Clin Gastroenterol. 2013 Jul;47(6):520-5. doi: 10.1097/MCG.0b013e31827fd4a2.
2
Recommendations for the nomenclature of IgG4-related disease and its individual organ system manifestations.IgG4相关疾病及其各器官系统表现的命名建议。
Arthritis Rheum. 2012 Oct;64(10):3061-7. doi: 10.1002/art.34593.
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Immunoglobulin G4 immunostaining of gastric, duodenal, or colonic biopsies is not helpful for the diagnosis of autoimmune pancreatitis.
双侧眼眶肿胀的罕见病因:一名溃疡性结肠炎患者发生的IgG4相关性眼眶疾病
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Gastrointestinal manifestation of immunoglobulin G4-related disease: clarification through a multicenter survey.免疫球蛋白 G4 相关疾病的胃肠道表现:多中心调查的阐明。
J Gastroenterol. 2018 Jul;53(7):845-853. doi: 10.1007/s00535-017-1420-4. Epub 2017 Dec 8.
胃、十二指肠或结肠活检的免疫球蛋白 G4 免疫染色对自身免疫性胰腺炎的诊断没有帮助。
Clin Gastroenterol Hepatol. 2012 Jan;10(1):91-4. doi: 10.1016/j.cgh.2011.09.008. Epub 2011 Sep 22.
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Clinical profile of autoimmune pancreatitis and its histological subtypes: an international multicenter survey.自身免疫性胰腺炎的临床特征及其组织学亚型:一项国际多中心调查。
Pancreas. 2011 Aug;40(6):809-14. doi: 10.1097/MPA.0b013e3182258a15.
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International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology.自身免疫性胰腺炎国际诊断共识标准:国际胰腺病学会指南。
Pancreas. 2011 Apr;40(3):352-8. doi: 10.1097/MPA.0b013e3182142fd2.
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Sclerosing nodular lesions of the gastrointestinal tract containing large numbers of IgG4 plasma cells.胃肠道内含有大量 IgG4 浆细胞的硬化性结节性病变。
Pathology. 2011 Jan;43(1):31-5. doi: 10.1097/PAT.0b013e328340e450.
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Numerous IgG4-positive plasma cells are ubiquitous in diverse localised non-specific chronic inflammatory conditions and need to be distinguished from IgG4-related systemic disorders.在各种局部非特异性慢性炎症性疾病中普遍存在大量 IgG4 阳性浆细胞,需要将其与 IgG4 相关的系统性疾病区分开来。
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