Jaber F, Elfert K, Alsakarneh S, Beran A, Jaber M, Gangwani MK, Abboud Y. Clinical characteristics and outcomes of autoimmune pancreatitis based on serum immunoglobulin G4 levels: A single-center, retrospective cohort study. World J Gastroenterol 2023; 29(47): 6161-6164 [PMID: 38186685 DOI: 10.3748/wjg.v29.i47.6161]
Corresponding Author of This Article
Fouad Jaber, MD, Doctor, Master's Student, Department of Internal Medicine, University of Missouri-Kansas City, No. 5000 Holmes St, Kansas, MO 64108, United States. fouad.jaber.md@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Fouad Jaber, Saqr Alsakarneh, Department of Internal Medicine, University of Missouri-Kansas City, Kansas, MO 64108, United States
Khaled Elfert, Department of Internal Medicine, SBH Health System, New York, NY 10457, United States
Azizullah Beran, Department of Gastroenterology, Indiana University, 420 University Blvd, Indianapolis, IN 46202, United States
Mohammed Jaber, Department of Medical Education, Al Azhar University School of Medicine, Gaza P.O.Box 108, Palestine
Manesh Kumar Gangwani, Department of Internal Medicine, The University of Toledo, Toledo, OH 43606, United States
Yazan Abboud, Department of Internal Medicine, Rutgers New Jersey Medical School, Newar, NJ 57873, United States
Author contributions: Jaber F conceived the research; Jaber F, Alsakarneh S, Elfert K designed the research workflow; Jaber F, Alsakarneh S, Abboud Y, and Jaber M wrote the final manuscript; Beran A and Gangwani MK supervised the project; all authors have read and agreed to the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fouad Jaber, MD, Doctor, Master's Student, Department of Internal Medicine, University of Missouri-Kansas City, No. 5000 Holmes St, Kansas, MO 64108, United States. fouad.jaber.md@gmail.com
Received: September 22, 2023 Peer-review started: September 22, 2023 First decision: November 1, 2023 Revised: November 10, 2023 Accepted: November 21, 2023 Article in press: November 21, 2023 Published online: December 21, 2023 Processing time: 88 Days and 0.1 Hours
Abstract
Autoimmune pancreatitis (AIP) is a complex, poorly understood disease gaining increasing attention. "Clinical Characteristics and Outcome of AIP Based on Serum IgG4 levels," investigated AIP with a focus on serum immunoglobulin (Ig) G4 levels. The 213 patients with AIP were classified according to serum IgG4 levels: Abnormal (elevated) and normal. Patients with higher IgG4 levels exhibited a more active immune system and increased relapse rates. Beyond IgG4, the IgA levels and age independently contributed to relapse risk, guiding risk assessment and tailored treatments for better outcomes. However, limitations persist, such as no IgA correlation with IgG4 levels, absent data on autoantibody-positive AIP cases critical for Asian diagnostic criteria, and unexplored relapse rates in high serum IgG AIP by subtype. Genetic factors and family histories were not addressed. As the understanding and referral of seronegative AIPs increase, there's a growing need for commercially available, highly sensitive, and specific autoantibodies to aid in diagnosing individuals with low or absent serum IgG4 levels.
Core Tip: The study on autoimmune pancreatitis (AIP) based on serum immunoglobulin (Ig) G4 levels offers valuable insights into this complex condition. Elevated IgG4 and IgA levels in patients with AIP were associated with more active immune system and higher relapse rates, highlighting the potential of IgG4 as a biomarker. However, limitations include the lack of analysis on IgA levels in relation to IgG4 levels, the absence of data on autoantibodies, and the lack of reporting on family history and genetic factors. As awareness of AIP grows, there is a need for highly sensitive and specific autoantibodies to aid in diagnosis, especially for IgG4-negative AIP patients.
