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Case of IgG4-associated sclerosing cholangitis with normal serum IgG4 concentration, diagnosed by anti-laminin 511-E8 antibody: a novel autoantibody in patients with autoimmune pancreatitis
  1. Yukari Kato1,
  2. Keishiro Azuma1,
  3. Hitoshi Someda1,
  4. Masahiro Shiokawa2,
  5. Tsutomu Chiba1,2
  1. 1Department of Gastroenterology and Hepatology, Kansai Electric Power Hospital, Osaka, Japan
  2. 2Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
  1. Correspondence to Dr Yukari Kato, Department of Gastroenterology and Hepatology, Kansai Electric Power Hospital, Osaka 553-0003, Japan; yukapon.kakesu{at}gmail.com

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We read with great interest the article by Hubers et al published in Gut.1 They identified annexin A11 as an autoantigen in IgG4-associated cholangitis (IAC) and autoimmune pancreatitis (AIP), which is targeted by IgG4 and IgG1 antibodies in the sera of IAC/AIP patients.1 Notably, they reported that none of the 20 patients tested for primary sclerosing cholangitis (PSC) had anti-annexin A11 antibodies. Thus, the measurement of these antibodies  is helpful in differentiating IAC from PSC. In addition to the anti-annexin A11 antibodies, we recently reported another autoantibody, anti-laminin 511-E8 antibody, in patients with AIP.2 Here, we show a case of IAC/AIP with a normal serum IgG4 concentration and no infiltration of IgG4 plasma cells in the biliary duct, whose diagnosis was made by measuring the anti-laminin 511-E8 antibody. 

A 57-year-old man visited our hospital in 2005 for swelling of pancreas. Contrast-enhanced CT and …

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