title: Lower incidence of biliary carcinoma in patients with primary sclerosing cholangitis and high serum levels of immunoglobulin E.
abstract: OBJECTIVE
  High serum levels of immunoglobulin (Ig)E often are detected in patients with primary sclerosing cholangitis (PSC), but the clinical significance is not known.
  
  
  METHODS
  We analyzed data from 44 patients with PSC and known serum levels of IgE. They were divided into groups called high IgE (>170 IU/mL; n = 17) or normal IgE (n = 27). We compared occurrence of biliary carcinoma including cholangiocellular and gallbladder carcinoma, liver transplantation, and death between groups.
  
  
  RESULTS
  The high IgE group had a later age of onset of PSC than the normal IgE group (54 ± 20 y vs 39 ± 16 y; P = .010); they also had a higher serum level of IgG (2078 ± 638 vs 1517 ± 475 mg/dL; P = .002) and IgG4 (104 ± 102 vs 38 ± 16 mg/dL; P = .002). Association with inflammatory bowel disease did not differ significantly between groups (5 of 17 vs 11 of 27; P = .661). No patient had biliary carcinoma in the high IgE group, but biliary carcinoma was observed during the follow-up period in 8 patients in the normal IgE group (0 of 17 vs 8 of 27; P = .016). The occurrence of biliary carcinoma, liver transplantation, or death did not differ between groups (4 of 17 vs 13 of 27; P = .124).
  
  
  CONCLUSIONS
  High serum levels of IgE often are observed in older patients with PSC and are associated with a reduced incidence of biliary carcinoma.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. khiranotky@umin.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Suguru
authors.initials: S
authors.lastname: Mizuno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Naminatsu
authors.initials: N
authors.lastname: Takahara
authors.forename: Rie
authors.initials: R
authors.lastname: Nagano
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamada
authors.forename: Koji
authors.initials: K
authors.lastname: Miyabayashi
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Ito
authors.forename: Dai
authors.initials: D
authors.lastname: Mohri
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Kawakubo
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Natsuyo
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Noriyo
authors.initials: N
authors.lastname: Yamashiki
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Nobuo
authors.initials: N
authors.lastname: Toda
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000453:epidemiology* / Q000401:mortality; D002277:Carcinoma / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D015209:Cholangitis, Sclerosing / Q000150:complications*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D015994:Incidence; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E