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Prevalence of elevated serum igg4 concentrations in patients with idiopathic recurrent pancreatitis



Prevalence of elevated serum igg4 concentrations in patients with idiopathic recurrent pancreatitis



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No T1599



Background: Autoimmunity is a rare but important cause of idiopathic recurrent pancreatitis. It has been recently reported, mostly from Japan, that autoimmune pancreatitis is associated with elevated IgG4 levels. The aim of this study is to determine the prevalence of elevated IgG4 among patients with idiopathic recurrent pancreatitis at a United States tertiary referral facility. Methods: The serum IgG4 levels of consecutive patients referred for evaluation of idiopathic recurrent pancreatitis (>1 episode) was measured using a single radial immunodiffusion assay. All patients identified to have a known etiology of pancreatitis such as alcohol, pancreas divisum, sphincter of Oddi dysfunction, gallstones, etc were excluded from the study. Results: Twenty patients (15 female, 5 male) with idiopathic recurrent pancreatitis were evaluated prospectively over a 9-month period (10/01-08/02) at the Medical University of South Carolina Digestive Disease Center. The mean age of the 20 patients was 45.2 yrs (range, 3-65). Two of 20 patients (10%) had elevated IgG4 levels: 95 mg/dl and 232 mg/dl respectively (normal range, 7-89 mg/dl). Both patients were male, aged 27 and 29 respectively; one patient was an Asian Indian and the other of Turkish descent. Eighteen other patients with normal IgG4 levels included 14 Caucasians and 4 African-Americans. While MRCP in one patient with elevated IgG4 levels showed a dilated main pancreatic duct with prominent side branches, pancreatogram in the other patient was normal. Conclusions: Ten percent of patients referred for evaluation of idiopathic recurrent pancreatitis in this study had elevated IgG4 levels suggesting an autoimmune etiology. Larger studies with a heterogeneous group of patients will be required to determine the prevalence of autoimmune pancreatitis in the Western population.

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Accession: 035548805

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