Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2012; 18(21): 2649-2653
Published online Jun 7, 2012. doi: 10.3748/wjg.v18.i21.2649
Association between autoimmune pancreatitis and systemic autoimmune diseases
Viktória Terzin, Imre Földesi, László Kovács, Gyula Pokorny, Tibor Wittmann, László Czakó
Viktória Terzin, Imre Földesi, Tibor Wittmann, László Czakó, First Department of Medicine, University of Szeged, H-6701 Szeged, Hungary
László Kovács, Gyula Pokorny, Department of Rheumatology, University of Szeged, H-6701 Szeged, Hungary
Author contributions: Czakó L and Terzin V made substantial contributions to study conception and design, contributed to the acquisition, analysis and interpretation of the data; Terzin V analyzed the data; Czakó L performed ultrasound examinations; Földesi I performed the IgG4 assay; Kovács L recruited the patients; Pokorny G, Wittmann T and Czakó L revised the article critically for important intellectual content; all authors approved the manuscript.
Supported by Grants TÁMOP-4.2.1./B-09/1/KONV and 4.2.2-08/1-2008-0002 (partly)
Correspondence to: László Czakó, MD, PhD, First Department of Medicine, University of Szeged, P.O. Box, 427, H-6701 Szeged, Hungary. czako.laszlo@med.u-szeged.hu
Telephone: +36-62-545187 Fax: +36-62-545185
Received: September 5, 2011
Revised: January 5, 2012
Accepted: April 10, 2012
Published online: June 7, 2012
Abstract

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.

Keywords: Autoimmune pancreatitis, Serum immunoglobulin G4 level, Systemic lupus erythematosus, Sjögren’s syndrome, Mikulicz’s disease