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- Title
Association between serum IgG level and clinical course in primary sclerosing cholangitis.
- Authors
Hippchen, Theresa; Sauer, Peter; Göppert, Benjamin; Schirmacher, Peter; Gotthardt, Daniel Nils; Weiss, Karl-Heinz; Stremmel, Wolfgang; Rupp, Christian
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>We identified elevated serum IgG levels at first diagnosis as an independent risk factor for reduced transplant free-survival in patients with PSC.
- Subjects
CHOLANGITIS; INFLAMMATORY bowel diseases; CHRONIC active hepatitis; IMMUNOGLOBULIN G; LIVER diseases; BIOMARKERS
- Publication
BMC Gastroenterology, 2019, Vol 19, Issue 1, pN.PAG
- ISSN
1471-230X
- Publication type
Journal Article
- DOI
10.1186/s12876-019-1075-0