Development of a scoring system for differentiating IgG4-related sclerosing cholangitis from primary sclerosing cholangitis

被引：22

作者：

Moon, Sung-Hoon ^{[1
]}

Kim, Myung-Hwan ^{[2
]}

Lee, Jong Kyun ^{[3
]}

Baek, Seunghee ^{[4
]}

Woo, Young Sik ^{[3
]}

Cho, Dong Hui ^{[2
]}

Oh, Dongwook ^{[2
]}

Song, Tae Jun ^{[2
]}

Park, Do Hyun ^{[2
]}

Lee, Sang Soo ^{[2
]}

Seo, Dong Wan ^{[2
]}

Lee, Sung Koo ^{[2
]}

机构：

[1] Hallym Univ, Sacred Heart Hosp, Dept Internal Med, Coll Med, Anyang, South Korea

[2] Univ Ulsan, Dept Internal Med, Asan Med Ctr, Coll Med, Asanbyeongwon Gil 86, Seoul 138736, South Korea

[3] Sungkyunkwan Univ, Dept Med, Samsung Med Ctr, Sch Med, 81 Irwon Ro, Seoul, South Korea

[4] Univ Ulsan, Dept Clin Epidemiol & Biostat, Asan Med Ctr, Coll Med, Seoul, South Korea

来源：

JOURNAL OF GASTROENTEROLOGY | 2017年 / 52卷 / 04期

关键词：

IgG4-related sclerosing cholangitis; Primary sclerosing cholangitis; Diagnosis; Scoring system; IMMUNOGLOBULIN G4-ASSOCIATED CHOLANGITIS; ENDOSCOPIC RETROGRADE CHOLANGIOGRAPHY; AUTOIMMUNE PANCREATITIS; IGG4-ASSOCIATED CHOLANGITIS; DIAGNOSIS; IGG4; INVOLVEMENT; BILE; G4; EPIDEMIOLOGY;

D O I：

10.1007/s00535-016-1246-5

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Recent research has shown that a substantial number of patients with primary sclerosing cholangitis (PSC) can also have elevated serum/tissue IgG4. The aim of our study was to develop a simple scoring system for the discrimination of IgG4-related sclerosing cholangits (IgG4-SC) from PSC. Methods Patients with IgG4-SC (n = 39) and PSC (n = 76) who had intrahepatic/hilar strictures were included. Candidate-differentiating variables included patient age, other organ involvement (OOI), inflammatory bowel disease, serum IgG4, and cholangiographic features. A scoring system was developed on the basis of these variables, and its performance was internally validated using a bootstrapping-based method. Results The scoring system in the final model included age (< 30 years, 0 points; 30-39 years, 1 point; 40-49 years, 2 points; 50-59 years, 3 points; ae<yen>60 years, 4 points), OOI (no, 0 points; yes, 3 points), and beaded appearance (yes, 0 points; no, 2 points). The patients were classified according to their total score into three categories: 0-4 points, probable PSC; 5-6 points, indicating diagnostic steroid trial; 7-9 points, probable IgG4-SC. The discrimination between IgG4-SC and PSC using the scoring system was excellent (area under the receiver operating characteristic curve, 0.986). Conclusion A reliable differentiation of IgG4-SC from PSC can be made using the scoring system presented here. We suggest the diagnosis of IgG4-SC at a cutoff of 7 points or higher and the indication of diagnostic steroid trial at 5 or 6 points. External validation of our scoring system is warranted.

引用

页码：483 / 493

页数：11