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.
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.
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。
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