title: The utility of IgG, IgM, and CD138 immunohistochemistry in the evaluation of autoimmune liver diseases.
abstract: Primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH) present with distinct clinical features. The term "PBC-AIH overlap syndrome (OS)" has been adopted to describe the condition characterized by occurrence of both PBC and AIH, although this clinical entity is difficult to define. This study aimed to assess the utility of IgG, IgM, and CD138 immunohistochemistry in the evaluation of AIH, PBC, and OS. Immunohistochemistry was performed with anti-human IgG, IgM, and CD138 to detect specific plasma cells in the liver. Predominant IgG staining was observed in AIH (85.7 %), while equivocal (46.1 %) or predominant (38.5 %) IgM staining was observed in PBC. In OS, equivocal (20 %) or predominant (80 %) IgG staining was observed. The IgM/IgG ratio was significantly higher in PBC than in AIH or OS (P < 0.005). Histological findings revealed significantly higher IgM expression in PBC at cholangitis activity grades 2-3 compared to those at cholangitis activity grades 0-1. In contrast, a significantly higher IgG expression was observed in PBC at hepatitis activity and fibrosis grades 2-3 compared to those at hepatitis activity and fibrosis grades 0-1. Taken together, periportal plasmacytic infiltrates with variable immunohistochemistry patterns of IgG and IgM expression characterized different autoimmune liver diseases.
authors: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan, k-abe@fmu.ac.jp.
authors: Kazumichi
authors: K
authors: Abe
authors: Atsushi
authors: A
authors: Takahashi
authors: Yoshihiro
authors: Y
authors: Nozawa
authors: Hiromichi
authors: H
authors: Imaizumi
authors: Manabu
authors: M
authors: Hayashi
authors: Ken
authors: K
authors: Okai
authors: Yukiko
authors: Y
authors: Kanno
authors: Hiroshi
authors: H
authors: Watanabe
authors: Hiromasa
authors: H
authors: Ohira
mesh_terms: D000367:Age Factors; D000469:Alkaline Phosphatase / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D019693:Hepatitis, Autoimmune / Q000175:diagnosis*; D006652:Histological Techniques; D006801:Humans; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007150:Immunohistochemistry / Q000379:methods; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis*; D008297:Male; D012737:Sex Factors; D018709:Statistics, Nonparametric; D053668:Syndecan-1; D013577:Syndrome; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; C508241:SDC1 protein, human; D053668:Syndecan-1; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase