ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2011
Elevated serum IgG4 is associated with chronic antibiotic-refractory pouchitis.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 36 citations in OpenAlex.
- Personalized Approach to Chronic Antibiotic-Refractory Pouchitis: A Case Report and Review of the Literature.Cureus · 2024Article
- Case report and review of literature: IgG4-gastroduodenitis in upper GI Crohn's disease: two separate entities or just a marker of disease severity?Frontiers in medicine · 2024Article
- The aetiology of pouchitis in patients with inflammatory bowel disease.Therapeutic advances in gastroenterology · 2024Review
- Pre-pouch Ileitis is Associated with Development of Crohn's Disease-like Complications and Pouch Failure.Journal of Crohn's & colitis · 2021Article
- High level of IgG4 as a biomarker for a new subset of inflammatory bowel disease.Scientific reports · 2018Article
- Review article: the pathogenesis of pouchitis.Alimentary pharmacology & therapeutics · 2016Review
- Update on the pathogenesis and management of pouchitis.Current infectious disease reports · 2014Article
- Acute and chronic pouchitis--pathogenesis, diagnosis and treatment.Nature reviews. Gastroenterology & hepatology · 2012Review
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6 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimWe recently reported mucosal infiltration of IgG4-expressing plasma cells in a patient with chronic antibiotic-refractory pouchitis (CARP). The role of serum IgG4 in the pathogenesis and clinical course of ileal pouch disorders has not been investigated. We hypothesized that IgG4-mediated autoimmunity may be a contributing factor in for CARP. The aims of the study were to investigate the prevalence of elevated serum IgG4 in symptomatic patients with ileal pouches and to characterize clinical features of pouch disorders in these patients.
methodsA total of 124 consecutive symptomatic patients with ileal pouches from our subspecialty Pouchitis Clinic were enrolled in the study from January to October 2010. Serum IgG4 was measured at the time of presentation. Demographic, clinical, and laboratory characteristics were compared between the study (with serum IgG4 ≥112 mg/dl) and control (with serum IgG4 <112 mg/dl) groups.
resultsThere were ten patients (8.0%) with high serum IgG4 in the study group, while the remaining 114 (92%) patients were in the control group. The prevalence of elevated serum IgG4 in this series was 8%. None of the patients had a confirmed diagnosis of autoimmune pancreatitis. The median serum IgG4 in the study group was 144.5 vs. 14 mg/dl in the control group. The mean age of patients in the study and control groups was 35.5 ± 14.5 and 42.0 ± 13.2 years, respectively (p = 0.137). Two patients in the study group (20.0%) had concurrent autoimmune disorders as compared to 19 patients (16.7%) in the control group (p = 0.788). Three (30.0%) patients in the study group had coexisting primary sclerosing cholangitis (PSC) in contrast to 15 (13.2%) in the control group (p = 0.147). Among the study group patients, five (50.0%) had CARP and one (10%) had Crohn's disease (CD) of the pouch, while in the control group, 23 (20.2%) had CARP and 24 (21.1%) patients had CD of the pouch (p = 0.273). CARP was more commonly seen in patients with high serum IgG4 than patients with a normal IgG4 (50.0% vs. 20.2%, p = 0.03).
conclusionsApproximately 8% of pouch patients presenting with symptoms of pouch dysfunction to our clinic had elevated serum IgG4. Patients with elevated serum IgG4 were more likely to have CARP.
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