BMC gastroenterology, 2019-08, Vol.19 (1), p.153-153, Article 153
2019
Details
- Autor(en) / Beteiligte
- Titel
- Association between serum IgG level and clinical course in primary sclerosing cholangitis
- Ist Teil von
- BMC gastroenterology, 2019-08, Vol.19 (1), p.153-153, Article 153
- Ort / Verlag
- England: BioMed Central Ltd
- Erscheinungsjahr
- 2019
- Link zum Volltext
- Quelle
- SpringerLink (Online service)
- Beschreibungen/Notizen
- Primary sclerosing cholangitis is a chronic cholestatic liver disease. The pathomechanism is still not fully understood, but there is evidence that immune-mediated processes may contribute to disease progression. We studied the prognostic relevance of serum immunoglobulin G (IgG) elevated above the upper limit of normal as a marker for immune activation at initial diagnosis and its influence on transplantation-free survival in a well-defined cohort of PSC patients. The final study cohort comprises of 148 PSC patients. Elevated IgG levels were found in 66 patients (44.6%). Apart from their younger age at first diagnosis, there was no significant difference between patients with or without elevated IgG levels. The presence of a concomitant inflammatory bowel disease, an autoimmune hepatitis or immunosuppressive medication was equally distributed between both groups. Patients with elevated IgG levels reached the combined endpoint (34 (59.6%) vs. 23 (40.4%); p = 0.004) significantly more often and had reduced transplantation-free survival (Log-rank: 24.0 (10.2-37.9) vs. 14.0 (8.5-19.5); p < 0.05). Cox regression analysis including age, gender, presence of IBD, presence of dominant stricture (DS), Mayo Risk Score (MRS), immunosuppression, biochemical response to UDCA and elevated IgG-levels confirmed MRS (p = 0.03), DS (p = 0.04), biochemical response (p = 0.04) and elevated IgG level (p = 0.04) as independent risk factors for reduced transplantation-free survival. We identified elevated serum IgG levels at first diagnosis as an independent risk factor for reduced transplant free-survival in patients with PSC.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 1471-230XeISSN: 1471-230XDOI: 10.1186/s12876-019-1075-0Titel-ID: cdi_doaj_primary_oai_doaj_org_article_12344834ad2e427bbdaaf5a7936fbfd6
- Format
- –
- Schlagworte
- Adult, Autoimmune hepatitis, Autoimmunity, Bile, Biomarkers - blood, Cholangitis, Cholangitis, Sclerosing - diagnosis, Cholangitis, Sclerosing - immunology, Cholangitis, Sclerosing - mortality, Cholangitis, Sclerosing - surgery, Cholestasis - diagnosis, Cholestasis - etiology, Cholestatic liver disease, Chronic active hepatitis, Development and progression, Diagnosis, Disease Progression, Female, Genetic aspects, Germany - epidemiology, Hepatitis, Hepatitis, Autoimmune - complications, Hepatitis, Autoimmune - diagnosis, Hepatitis, Autoimmune - epidemiology, Humans, Hypergammaglobulinaemia, Immune response, Immunoglobulin G, Immunoglobulin G - blood, Immunoglobulins, Immunology, Immunosuppression, Immunotherapy, Inflammatory bowel disease, Inflammatory bowel diseases, Intestine, Laboratories, Liver, Liver cirrhosis, Liver Cirrhosis, Biliary - diagnosis, Liver Cirrhosis, Biliary - etiology, Liver diseases, Liver Transplantation - statistics & numerical data, Male, Medical research, Open access publishing, Outcome and Process Assessment, Health Care, Pathogenesis, Patients, Predictive Value of Tests, Primary sclerosing cholangitis, Prognosis, Regression analysis, Risk Factors, Stricture, Surgery, Survival, Survival Analysis, Transplantation