| Small bile duct involvement in IgG4-related sclerosing cholangitis: liver biopsy and cholangiography correlation. | |
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MedLine Citation:
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PMID: 20821235 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: IgG4-related sclerosing cholangitis (IgG4-SC) needs to be differentiated from primary sclerosing cholangitis (PSC). In this study, we performed a retrospective study to reveal cases in which liver needle biopsy was useful for differential diagnosis. METHODS: Nineteen patients with IgG4-SC and 22 patients with PSC were studied. All patients underwent endoscopic retrograde cholangiography and liver needle biopsy. We defined small bile duct involvement of IgG4-SC histologically as damage to the small bile duct associated with infiltration of ≥10 IgG4+ plasma cells per high power field (HPF). Clinicopathological characteristics were compared between IgG4-SC patients with and without small bile duct involvement. RESULTS: Small bile duct involvement was observed in 5 (26%) of the patients with IgG4-SC. Patients with small bile duct involvement showed a higher incidence of intrahepatic biliary strictures on cholangiography (80 vs. 21%, p = 0.038). Conversely, 4 of 7 (57%) patients with intrahepatic biliary strictures on cholangiography had histologically evident small duct involvement. The number of IgG4+ plasma cells was significantly correlated with the site of the most proximal stricture on cholangiograms (p = 0.021). The number of IgG4+ plasma cells per HPF was significantly higher in IgG4-SC patients with intrahepatic biliary strictures than in those with PSC (13.4 vs. 0.4 cells/HPF, p < 0.001). CONCLUSIONS: Involvement of small bile ducts is more frequent in patients with intrahepatic biliary strictures on cholangiography, and liver needle biopsy is especially useful for these patients. |
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Authors:
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Itaru Naitoh; Yoh Zen; Takahiro Nakazawa; Tomoaki Ando; Kazuki Hayashi; Fumihiro Okumura; Katsuyuki Miyabe; Michihiro Yoshida; Shunsuke Nojiri; Takayoshi Kanematsu; Hirotaka Ohara; Takashi Joh |
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Publication Detail:
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Type: Journal Article Date: 2010-09-07 |
Journal Detail:
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Title: Journal of gastroenterology Volume: 46 ISSN: 1435-5922 ISO Abbreviation: J. Gastroenterol. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9430794 Medline TA: J Gastroenterol Country: Japan |
Other Details:
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Languages: eng Pagination: 269-76 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan. |
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