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Immunoglobulin G4-positive plasma cell infiltration in explanted livers for primary sclerosing cholangitis.
MedLine Citation:
PMID:  21348891     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Zen Y, Quaglia A & Portmann B (2011) Histopathology Immunoglobulin G4-positive plasma cell infiltration in explanted livers for primary sclerosing cholangitis Aims:  To explore whether immunoglobulin (Ig)G4-related sclerosing cholangitis (IgG4-SC) contributes to end-stage primary sclerosing cholangitis (PSC) in the United Kingdom. Methods and results:  This study consisted of 41 patients who underwent liver transplantation for advanced PSC. Explanted livers were examined histologically with an emphasis on IgG4-positive plasma cell infiltration. Thirty-nine cases (95%) had minimal or mild infiltration of IgG4-positive plasma cells (≤30 cells/high-power field). In contrast, two cases (5%) showed plasma cell IgG4-positivity in more than 100 cells/high-power field. IgG4-positive plasma cells were accumulated preferentially in a (xantho)granulomatous tissue within large bile ducts. Except for the presence of IgG4-positive plasma cells, there was no significant histological difference between IgG4-positive and negative cases. Both showed sclerosing cholangitis with bile duct erosion and xanthogranulomatous reaction more in keeping with PSC than typical IgG4-SC. Clinically, the two patients differed from typical IgG4-related disease, in that both had associated ulcerative colitis, and one of them was younger than expected for IgG4-SC (28 years old). Conclusions:  No classical IgG4-SC could be identified in patients explanted for PSC. The two cases identified with numerous IgG4-positive plasma cells suggest a superimposed immune mechanism of uncertain nature. A prospective study is needed to assess whether such cases will be steroid-sensitive.
Authors:
Yoh Zen; Alberto Quaglia; Bernard Portmann
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-23
Journal Detail:
Title:  Histopathology     Volume:  -     ISSN:  1365-2559     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704136     Medline TA:  Histopathology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Limited.
Affiliation:
Institute of Liver Studies, King's College Hospital, London, UK.
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