title: The impact of elevated serum IgG4 levels in patients with primary sclerosing cholangitis.
abstract: BACKGROUND
  Elevated IgG4 levels have been reported among patients with primary sclerosing cholangitis. Epidemiological data has only been provided from tertiary centres.
  
  
  OBJECTIVE
  To investigate the prevalence of elevated IgG4 levels and to compare prognosis between patients with and without elevated IgG4 levels in serum in two European cohorts of patients with primary sclerosing cholangitis.
  
  
  METHODS
  Serum IgG4-levels were measured in a consecutive series of patients from Berlin, and retrospectively collected in a population-based cohort from Sweden (total N=345). Cox's proportional hazard analysis was used to calculate relative risks for liver-related death or liver transplantation and cholangiocarcinoma.
  
  
  RESULTS
  Elevated IgG4 values were demonstrated in 10% of patients. A previous history of pancreatitis, combined intra- and extrahepatic biliary involvement and jaundice were independently associated with elevated IgG4 in multivariate analysis. IgG4 status was not associated with an increased risk for the combined endpoint liver-related death or liver transplantation or cholangiocarcinoma.
  
  
  CONCLUSIONS
  The prevalence of elevated IgG4 values among European patients with primary sclerosing cholangitis is similar to what previously has been reported from the United States. Elevated IgG4 was not associated with an increased risk of liver transplantation or liver-related death or cholangiocarcinoma.
authors.affiliation: Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Benito de Valle
authors.affiliation: Institute of Medicine, Hepatology and Gastroenterology, University Hospital Charité, Campus Virchow Clinic, Berlin, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Müller
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology and Hepatology, The National University Hospital, Reykjavik, Iceland.
authors.forename: Einar
authors.initials: E
authors.lastname: Björnsson
authors.affiliation: Occupational Health Centrum, University Hospital The Charité, Campus Virchow Clinic, Berlin, Germany.
authors.forename: Morgane
authors.initials: M
authors.lastname: Otten
authors.affiliation: MVZ Labor Prof. Seelig, Karlsruhe, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Volkmann
authors.affiliation: General and Transplantation Surgery Clinic, University Hospital The Charité, Campus Virchow Clinic, Berlin, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Guckelberger
authors.affiliation: Institute of Medicine, Hepatology and Gastroenterology, University Hospital Charité, Campus Virchow Clinic, Berlin, Germany.
authors.forename: Bertram
authors.initials: B
authors.lastname: Wiedenmann
authors.affiliation: Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
authors.forename: Riadh
authors.initials: R
authors.lastname: Sadik
authors.affiliation: Institute of Medicine, Hepatology and Gastroenterology, University Hospital Charité, Campus Virchow Clinic, Berlin, Germany.
authors.forename: Eckart
authors.initials: E
authors.lastname: Schott
authors.affiliation: Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Andersson
authors.affiliation: Gastroenterology and Reumatology Clinic, Hepatology Section, University Hospital Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Berg
authors.affiliation: Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: bjorn.lindkvist@vgregion.se.
authors.forename: Björn
authors.initials: B
authors.lastname: Lindkvist
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000209:etiology; D001653:Bile Ducts, Intrahepatic; D015415:Biomarkers / Q000097:blood; D002648:Child; D018281:Cholangiocarcinoma / Q000209:etiology; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000276:immunology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G
keywords: IgG4 status; Prevalence; Survival