Antibodies to carbonic anhydrase and IgG4 levels in idiopathic chronic pancreatitis: relevance for diagnosis of autoimmune pancreatitis.

Abstract

BACKGROUND:

Increased serum antibodies against carbonic anhydrase II (CA-II Ab) or IgG4 levels have been reported in cases of autoimmune chronic pancreatitis (ACP).

AIM:

To assess the relevance of serum CA-II Ab and IgG4 levels for the diagnosis of ACP in idiopathic CP (ICP) versus alcoholic CP and Sjogren's syndrome (SS).

SUBJECTS:

This was a multicentre study involving 227 subjects divided into four groups: ICP (n = 54), normal controls (n = 54, paired by age and sex with ICP patients), alcoholic CP (n = 86), and SS (n = 33).

METHODS:

CA-II Ab was measured by ELISA and confirmed by western blotting. A score of easy clinical use with major clinical, morphological, and biochemical parameters for the diagnosis of ACP was applied.

RESULTS:

The percentage of patients with increased serum CA-II Ab was higher in the ICP group (28%) than in controls (1.9%) and in patients with alcoholic CP (10.5%), but lower than in patients with SS (64%). The proportion with elevated IgG4 levels was higher in the ICP group (15%) compared with controls (1.9%) and SS (0%) but not significantly different from alcoholic CP (8%). Most ICP patients (7/8) with high IgG4 levels exhibited increased CA-II Ab and a compatible ACP score. A definitive diagnosis of ACP by histological analysis was associated with other autoimmune disorders, an increase in both serum IgG4 and CA-II Ab levels, and IgG4 positive plasma cells.

CONCLUSIONS:

The increase in serum IgG4 levels was strongly associated with elevated CA-II Ab levels, manifestations compatible with ACP, and lymphoplasmacytic infiltration when surgical specimens were available.

• Authors: L Aparisi, A Farre, L Gomez-Cambronero, J Martinez, G De Las Heras, J Corts, S Navarro, J Mora, M Lopez-Hoyos, L Sabater, A Ferrandez, D Bautista, M Perez-Mateo, S Mery, J Sastre
• Journal: Gut (Gut) Vol. 54 Issue 5 Pg. 703-9 (May 2005) ISSN: 0017-5749 [Print] England
• PMID: 15831920 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Autoantibodies
• Biomarkers
• Immunoglobulin G
• Carbonic Anhydrase II

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Autoantibodies (blood)
• Autoimmune Diseases (diagnosis, immunology, pathology)
• Biomarkers (blood)
• Carbonic Anhydrase II (immunology)
• Chronic Disease
• Diagnosis, Differential
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Immunoglobulin G (blood)
• Male
• Middle Aged
• Pancreatitis (diagnosis, immunology, pathology)
• Pancreatitis, Alcoholic (diagnosis, immunology)
• Plasma Cells (immunology)
• Sjogren's Syndrome (diagnosis, immunology)