title: Increased immunoglobulin G4-positive plasma cells in collagenous sprue.
abstract: Collagenous sprue is a rare enteropathy whose etiology is unknown, but immune-mediated mechanisms are one of several possibilities. However, the role of immunoglobulin G4 (IgG4)-positive plasma cells has not been studied in collagenous sprue. Endoscopic biopsies from the duodenum with a histologic diagnosis of collagenous sprue (n = 40 from 35 patients), celiac disease (n = 25), peptic duodenitis (n = 15) and normal duodenum (n = 25) were immunohistochemically stained with IgG4 and CD138 antibodies. For each case, the quantities of IgG4- and CD138-positive plasma cells in the lamina propria were estimated by averaging the number in 3 high-power fields (hpf) that showed the highest concentration. Nine of forty collagenous sprue samples showed a mean of 10 or more IgG4 plasma cells per hpf, whereas none of the duodenal control biopsies showed 10 or more IgG4 plasma cells per hpf: celiac disease (P = .01), peptic duodenitis (P = .05), and normal duodenum (P = .01). Our study demonstrates that increased IgG4-positive plasma cells are present in a subset (23%) of collagenous sprue and may play a role in its pathogenesis.
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: J Kenneth
authors.initials: JK
authors.lastname: Schoolmeester
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Jenkins
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Murray
authors.forename: Tsung-Teh
authors.initials: TT
authors.lastname: Wu
authors.forename: Vishal S
authors.initials: VS
authors.lastname: Chandan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D046729:Colitis, Collagenous / Q000276:immunology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology* / Q000473:pathology*; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G
keywords: Collagenous sprue; Duodenum; IgG4; Plasma cells