Autoimmune pancreatitis laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of autoimmune pancreatitis may include increased serum IgG4 levels and hypergammaglobulinemia (>2 times the upper limit of normal in most patients), antilactoferrin antibody, anticarbonic anhydrase II antibody, other autoantibodies (ANA), rheumatoid factor (RF), IgG4-positive plasma cells, elevated serum alkaline phosphatase levels (ALP), elevated serum aminotransferases, ESR, and CA19-9. | Laboratory findings consistent with the diagnosis of autoimmune pancreatitis may include increased [[serum]] IgG4 levels and [[hypergammaglobulinemia]] (>2 times the upper limit of normal in most patients), antilactoferrin antibody, anticarbonic anhydrase II antibody, other [[autoantibodies]] (ANA), [[rheumatoid factor]] (RF), IgG4-positive plasma cells, elevated [[serum]] [[alkaline phosphatase]] levels (ALP), elevated [[serum]] [[aminotransferases]], [[ESR]], and [[CA19-9]]. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
*Laboratory findings consistent with the diagnosis of autoimmune pancreatitis include:<ref name="pmid14614606">{{cite journal |vauthors=Kamisawa T, Funata N, Hayashi Y, Eishi Y, Koike M, Tsuruta K, Okamoto A, Egawa N, Nakajima H |title=A new clinicopathological entity of IgG4-related autoimmune disease |journal=J. Gastroenterol. |volume=38 |issue=10 |pages=982–4 |year=2003 |pmid=14614606 |doi=10.1007/s00535-003-1175-y |url=}}</ref><ref name="pmid15044886">{{cite journal |vauthors=Shinji A, Sano K, Hamano H, Unno H, Fukushima M, Nakamura N, Akamatsu T, Kawa S, Kiyosawa K |title=Autoimmune pancreatitis is closely associated with gastric ulcer presenting with abundant IgG4-bearing plasma cell infiltration |journal=Gastrointest. Endosc. |volume=59 |issue=4 |pages=506–11 |year=2004 |pmid=15044886 |doi= |url=}}</ref><ref name="pmid14736977">{{cite journal |vauthors=Takeda S, Haratake J, Kasai T, Takaeda C, Takazakura E |title=IgG4-associated idiopathic tubulointerstitial nephritis complicating autoimmune pancreatitis |journal=Nephrol. Dial. Transplant. |volume=19 |issue=2 |pages=474–6 |year=2004 |pmid=14736977 |doi= |url=}}</ref><ref name="pmid16508232">{{cite journal |vauthors=Saeki T, Saito A, Hiura T, Yamazaki H, Emura I, Ueno M, Miyamura S, Gejyo F |title=Lymphoplasmacytic infiltration of multiple organs with immunoreactivity for IgG4: IgG4-related systemic disease |journal=Intern. Med. |volume=45 |issue=3 |pages=163–7 |year=2006 |pmid=16508232 |doi= |url=}}</ref><ref name="pmid17634963">{{cite journal |vauthors=Umemura T, Zen Y, Hamano H, Kawa S, Nakanuma Y, Kiyosawa K |title=Immunoglobin G4-hepatopathy: association of immunoglobin G4-bearing plasma cells in liver with autoimmune pancreatitis |journal=Hepatology |volume=46 |issue=2 |pages=463–71 |year=2007 |pmid=17634963 |doi=10.1002/hep.21700 |url=}}</ref> | *Laboratory findings consistent with the diagnosis of autoimmune pancreatitis include:<ref name="pmid14614606">{{cite journal |vauthors=Kamisawa T, Funata N, Hayashi Y, Eishi Y, Koike M, Tsuruta K, Okamoto A, Egawa N, Nakajima H |title=A new clinicopathological entity of IgG4-related autoimmune disease |journal=J. Gastroenterol. |volume=38 |issue=10 |pages=982–4 |year=2003 |pmid=14614606 |doi=10.1007/s00535-003-1175-y |url=}}</ref><ref name="pmid15044886">{{cite journal |vauthors=Shinji A, Sano K, Hamano H, Unno H, Fukushima M, Nakamura N, Akamatsu T, Kawa S, Kiyosawa K |title=Autoimmune pancreatitis is closely associated with gastric ulcer presenting with abundant IgG4-bearing plasma cell infiltration |journal=Gastrointest. Endosc. |volume=59 |issue=4 |pages=506–11 |year=2004 |pmid=15044886 |doi= |url=}}</ref><ref name="pmid14736977">{{cite journal |vauthors=Takeda S, Haratake J, Kasai T, Takaeda C, Takazakura E |title=IgG4-associated idiopathic tubulointerstitial nephritis complicating autoimmune pancreatitis |journal=Nephrol. Dial. Transplant. |volume=19 |issue=2 |pages=474–6 |year=2004 |pmid=14736977 |doi= |url=}}</ref><ref name="pmid16508232">{{cite journal |vauthors=Saeki T, Saito A, Hiura T, Yamazaki H, Emura I, Ueno M, Miyamura S, Gejyo F |title=Lymphoplasmacytic infiltration of multiple organs with immunoreactivity for IgG4: IgG4-related systemic disease |journal=Intern. Med. |volume=45 |issue=3 |pages=163–7 |year=2006 |pmid=16508232 |doi= |url=}}</ref><ref name="pmid17634963">{{cite journal |vauthors=Umemura T, Zen Y, Hamano H, Kawa S, Nakanuma Y, Kiyosawa K |title=Immunoglobin G4-hepatopathy: association of immunoglobin G4-bearing plasma cells in liver with autoimmune pancreatitis |journal=Hepatology |volume=46 |issue=2 |pages=463–71 |year=2007 |pmid=17634963 |doi=10.1002/hep.21700 |url=}}</ref> | ||
**Increased serum IgG4 levels and hypergammaglobulinemia (>2 times the upper limit of normal in most patients). Using a cutoff of 135 mg/dL, serum IgG4 has following sensitivity and specificity: | **Increased [[serum]] IgG4 levels and [[hypergammaglobulinemia]] (>2 times the upper limit of normal in most patients). Using a cutoff of 135 mg/dL, serum IgG4 has following [[sensitivity]] and [[specificity]]: | ||
***Sensitivity 95% | ***[[Sensitivity]] 95% | ||
***Specificity 97% | ***[[Specificity]] 97% | ||
**Antilactoferrin antibody | **Antilactoferrin antibody | ||
**Anticarbonic anhydrase II antibody | **Anticarbonic anhydrase II [[antibody]] | ||
**Anti-plasminogen-binding protein (PBP) peptide antibodies<ref name="pmid19940298">{{cite journal |vauthors=Frulloni L, Lunardi C, Simone R, Dolcino M, Scattolini C, Falconi M, Benini L, Vantini I, Corrocher R, Puccetti A |title=Identification of a novel antibody associated with autoimmune pancreatitis |journal=N. Engl. J. Med. |volume=361 |issue=22 |pages=2135–42 |year=2009 |pmid=19940298 |doi=10.1056/NEJMoa0903068 |url=}}</ref> | **Anti-plasminogen-binding protein (PBP) peptide antibodies<ref name="pmid19940298">{{cite journal |vauthors=Frulloni L, Lunardi C, Simone R, Dolcino M, Scattolini C, Falconi M, Benini L, Vantini I, Corrocher R, Puccetti A |title=Identification of a novel antibody associated with autoimmune pancreatitis |journal=N. Engl. J. Med. |volume=361 |issue=22 |pages=2135–42 |year=2009 |pmid=19940298 |doi=10.1056/NEJMoa0903068 |url=}}</ref> | ||
**Rheumatoid factor (RF) | **[[Rheumatoid factor]] (RF) | ||
**IgG4-positive plasma cells | **IgG4-positive [[plasma cells]] | ||
**Elevated serum alkaline phosphatase levels (ALP) | **Elevated [[serum]] [[alkaline phosphatase]] levels (ALP) | ||
**Elevated serum aminotransferases | **Elevated [[serum]] [[aminotransferases]] | ||
**Elevated ESR | **Elevated [[ESR]] | ||
**Elevated CA19-9 | **Elevated [[CA19-9]] | ||
==References== | ==References== |
Revision as of 17:58, 5 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
Overview
Laboratory findings consistent with the diagnosis of autoimmune pancreatitis may include increased serum IgG4 levels and hypergammaglobulinemia (>2 times the upper limit of normal in most patients), antilactoferrin antibody, anticarbonic anhydrase II antibody, other autoantibodies (ANA), rheumatoid factor (RF), IgG4-positive plasma cells, elevated serum alkaline phosphatase levels (ALP), elevated serum aminotransferases, ESR, and CA19-9.
Laboratory Findings
- Laboratory findings consistent with the diagnosis of autoimmune pancreatitis include:[1][2][3][4][5]
- Increased serum IgG4 levels and hypergammaglobulinemia (>2 times the upper limit of normal in most patients). Using a cutoff of 135 mg/dL, serum IgG4 has following sensitivity and specificity:
- Sensitivity 95%
- Specificity 97%
- Antilactoferrin antibody
- Anticarbonic anhydrase II antibody
- Anti-plasminogen-binding protein (PBP) peptide antibodies[6]
- Rheumatoid factor (RF)
- IgG4-positive plasma cells
- Elevated serum alkaline phosphatase levels (ALP)
- Elevated serum aminotransferases
- Elevated ESR
- Elevated CA19-9
- Increased serum IgG4 levels and hypergammaglobulinemia (>2 times the upper limit of normal in most patients). Using a cutoff of 135 mg/dL, serum IgG4 has following sensitivity and specificity:
References
- ↑ Kamisawa T, Funata N, Hayashi Y, Eishi Y, Koike M, Tsuruta K, Okamoto A, Egawa N, Nakajima H (2003). "A new clinicopathological entity of IgG4-related autoimmune disease". J. Gastroenterol. 38 (10): 982–4. doi:10.1007/s00535-003-1175-y. PMID 14614606.
- ↑ Shinji A, Sano K, Hamano H, Unno H, Fukushima M, Nakamura N, Akamatsu T, Kawa S, Kiyosawa K (2004). "Autoimmune pancreatitis is closely associated with gastric ulcer presenting with abundant IgG4-bearing plasma cell infiltration". Gastrointest. Endosc. 59 (4): 506–11. PMID 15044886.
- ↑ Takeda S, Haratake J, Kasai T, Takaeda C, Takazakura E (2004). "IgG4-associated idiopathic tubulointerstitial nephritis complicating autoimmune pancreatitis". Nephrol. Dial. Transplant. 19 (2): 474–6. PMID 14736977.
- ↑ Saeki T, Saito A, Hiura T, Yamazaki H, Emura I, Ueno M, Miyamura S, Gejyo F (2006). "Lymphoplasmacytic infiltration of multiple organs with immunoreactivity for IgG4: IgG4-related systemic disease". Intern. Med. 45 (3): 163–7. PMID 16508232.
- ↑ Umemura T, Zen Y, Hamano H, Kawa S, Nakanuma Y, Kiyosawa K (2007). "Immunoglobin G4-hepatopathy: association of immunoglobin G4-bearing plasma cells in liver with autoimmune pancreatitis". Hepatology. 46 (2): 463–71. doi:10.1002/hep.21700. PMID 17634963.
- ↑ Frulloni L, Lunardi C, Simone R, Dolcino M, Scattolini C, Falconi M, Benini L, Vantini I, Corrocher R, Puccetti A (2009). "Identification of a novel antibody associated with autoimmune pancreatitis". N. Engl. J. Med. 361 (22): 2135–42. doi:10.1056/NEJMoa0903068. PMID 19940298.