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Sclerosing Pancreatitis Test.

Elevated serum concentrations of IgG4 distinguishes sclerosing pancreatitis from other pancreatic or biliary tract diseases, said Dr. Hideaki Hamano of Shinshu University School of Medicine in Matsumoto, Japan, and associates.

Serum IgG4 concentrations were measured in 20 patients with sclerosing pancreatitis and 20 matched controls by radial immunodiffusion (RI) or enzyme linked immunosorbent assay (ELISA). By either test, IgG4 was elevated in the patients with sclerosing pancreatitis (median 597 mg/dL for ELISA-663 mg/dL for RI) but not in the controls (41 mg/dL for ELISA-51 mg/dL for RI) (N. Engl. J. Med. 344[10]:732-38, 2001). Serum IgG4 concentrations were not elevated in 154 patients with other pancreatic or biliary tract diseases.

In 12 patients treated with glucocorticoids, serum concentration of IgG4 but not IgG decreased significantly after 4 weeks, suggesting that a decline in serum concentrations of IgG4 is a specific effect of glucocorticoid therapy.

Sclerosing pancreatitis is the only disease affecting the liver or biliary tract in which IgG4 level has been shown to be elevated. This test is a useful way to distinguish sclerosing pancreatitis from pancreatic cancer, which it resembles on endoscopic retrograde cholangiopancreatography, and diseases with similar features such as Sjogren's syndrome, primary biliary cirrhosis, and primary sclerosing cholangitis.
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Author:Kubetin, Sally Koch
Publication:Internal Medicine News
Geographic Code:9JAPA
Date:Sep 1, 2001
Words:207
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