Buechter Matthias, Manka Paul, Heinemann Falko Markus, Lindemann Monika, Juntermanns Benjamin, Canbay Ali, Gerken Guido, Kahraman Alisan
Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany; Division of Transplantation Immunology and Mucosal Biology, King's College London, London, UK.
Gastroenterol Res Pract. 2017;2017:6126707. doi: 10.1155/2017/6126707. Epub 2017 Mar 2.
. Most investigations on autoimmune pancreatitis (AIP) were published on Asian cohorts while those on Caucasians are limited. However, there might be differences related to the origin. . We analyzed 36 patients and compared type 1 (AIP1) with type 2 (AIP2). . The majority of patients suffered from AIP1 (55.6%). AIP1 patients were significantly older than AIP2 patients (54.4 versus 40.8 years). Moreover, 85.0% of AIP1 patients had concurrent autoimmune cholangitis (AIC) while 18.8% of AIP2 patients suffered from overlap to ulcerative colitis (UC). However, AIP1 patients revealed a cholestatic course and had significantly higher immunoglobulin G4 levels (IgG4). When compared to allele frequencies in healthy controls, in patients with AIP1 HLA-B8 reached statistical significance. Response to steroids was excellent in both groups, but we noticed high rates of relapse especially in AIP1 patients. Finally, 3 patients with AIP1 were diagnosed with cholangiocellular carcinoma (CCC). . In contrast to Asian studies, we found an almost equal distribution of AIP1 and AIP2 patients in our German cohort. AIP2 patients were younger and mostly of female gender whereas AIP1 patients revealed higher IgG4 levels and involvement of the biliary tract in sense of IgG4-associated cholangitis.
大多数关于自身免疫性胰腺炎(AIP)的研究发表于亚洲人群,而针对高加索人群的研究有限。然而,可能存在与种族相关的差异。我们分析了36例患者,并比较了1型(AIP1)和2型(AIP2)。大多数患者为AIP1(55.6%)。AIP1患者显著比AIP2患者年龄大(54.4岁对40.8岁)。此外,85.0%的AIP1患者并发自身免疫性胆管炎(AIC),而18.8%的AIP2患者与溃疡性结肠炎(UC)重叠。然而,AIP1患者呈现胆汁淤积病程且免疫球蛋白G4水平(IgG4)显著更高。与健康对照的等位基因频率相比,AIP1患者中HLA - B8具有统计学意义。两组对类固醇的反应均良好,但我们注意到复发率很高,尤其是AIP1患者。最后,3例AIP1患者被诊断为胆管细胞癌(CCC)。与亚洲研究不同,我们发现在我们的德国队列中AIP1和AIP2患者分布几乎相等。AIP2患者更年轻且大多为女性,而AIP1患者显示更高的IgG4水平以及在IgG4相关胆管炎意义上的胆道受累。