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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

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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. 1 Department of Gastroenterology and Hepatology, Kansai Electric Power Hospital, Osaka, Japan
  2. 2 Department 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

https://doi.org/10.1136/gutjnl-2018-317934

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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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    Footnotes

    • Contributors KA, YK and HS looked after the patient. MS measured anti-laminin 511-E8 antibody. KA, YK and TC wrote the report. Written consent to publish was obtained.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Kansai Electric Power Hospital Ethics Board.

    • Provenance and peer review Not commissioned; internally peer reviewed.