ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2018
The clinical utility of immunoglobulin G4 in the evaluation of autoimmune pancreatitis and pancreatic adenocarcinoma.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 19 citations in OpenAlex.
- Extrapancreatic Findings and Retrospective Diagnostic Pitfalls in Type 1 Autoimmune Pancreatitis: A Descriptive CT and MRI Study.Diagnostics (Basel, Switzerland) · 2026Article
- Clinical characteristics and outcome of autoimmune pancreatitis based on serum immunoglobulin G4 level: A single-center, retrospective cohort study.World journal of gastroenterology · 2023Article
- Diagnostic value of homogenous delayed enhancement in contrast-enhanced computed tomography images and endoscopic ultrasound-guided tissue acquisition for patients with focal autoimmune pancreatitis.Clinical endoscopy · 2023Article
- A multidomain fusion model of radiomics and deep learning to discriminate between PDAC and AIP based onJapanese journal of radiology · 2023Article
- Serum biomarkers for the differentiation of autoimmune pancreatitis from pancreatic ductal adenocarcinoma.World journal of gastrointestinal oncology · 2023Review
- Pancreatic Cancer Exposome Profile to Aid Early Detection and Inform Prevention Strategies.Journal of clinical medicine · 2021Review
- CT Image Changes of Severe Acute Pancreatitis Based on Smart Electronic Medical Augmented Reality in Nursing Practice.Journal of healthcare engineering · 2021Article
- Early pancreatic cancer in IgG4-related pancreatic mass: A case report.World journal of gastrointestinal surgery · 2019Article
- Pancreatic Ductal Adenocarcinoma Encapsulated by a Tumor-Forming Type 1 Autoimmune Pancreatitis Located at the Pancreatic Tail: A Case Report.Case reports in gastroenterologyArticle
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundElevation in the serum immunoglobulin-G4 (IgG4) level has been used as a diagnostic marker to distinguish autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC), but its true utility is ill-defined. This study evaluates the clinical utility of IgG4 in differentiating AIP from PDAC.
methodsAll patients evaluated in the hepatopancreaticobiliary surgery clinics with measured serum IgG4 were included. Patients were divided into normal IgG4 (<135 mg/dL) and elevated IgG4 (≥135 mg/dL) groups. The final diagnosis was determined by operative pathology when available or by clinical outcome. The sensitivity, specificity, PPV, and NPV of IgG4 for diagnosing AIP was assessed.
resultsBetween 1997 and 2015, 298 patients were identified. Normal IgG4 levels were present in 85% of patients (254/298), while 15% (44/298) were elevated. The overall prevalence of AIP was 17% (52/298). The sensitivity and specificity of IgG4 for AIP was 67% and 96%, respectively; however, the PPV was only 80%, including a 9% occurrence of PDAC in patients with an elevated IgG4.
conclusionIn this study of selected patients who underwent IgG4 testing, 9% of elevated IgG4 patients had PDAC. The overreliance on IgG4 as diagnostic for AIP may lead to mis-diagnosis and delayed treatment for PDAC.
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