Document Detail

Small bile duct involvement in IgG4-related sclerosing cholangitis: liver biopsy and cholangiography correlation.
MedLine Citation:
PMID:  20821235     Owner:  NLM     Status:  In-Data-Review    
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.
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:
Type:  Journal Article     Date:  2010-09-07
Journal Detail:
Title:  Journal of gastroenterology     Volume:  46     ISSN:  1435-5922     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  269-76     Citation Subset:  IM    
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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