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Ulcerative colitis and immunoglobulin G4.

Go Kuwata¹, Terumi Kamisawa¹, Koichi Koizumi¹

¹Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.

|February 12, 2014

Summary

Ulcerative colitis (UC) can be linked to autoimmune pancreatitis (AIP). Infiltrating immunoglobulin G4 (IgG4)-positive cells in UC patients correlate with disease severity, but UC is not a manifestation of IgG4-related disease.

Keywords:

Autoimmune pancreatitis Colitis, ulcerative Immunoglobulin G

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Area of Science:

Gastroenterology
Immunology
Pathology

Background:

Ulcerative colitis (UC) and autoimmune pancreatitis (AIP) share some associations.
Immunoglobulin G4 (IgG4)-positive plasma cells are found in the colonic mucosa of some AIP and UC patients.

Purpose of the Study:

To investigate the relationship between ulcerative colitis (UC) and immunoglobulin G4 (IgG4).
To determine if IgG4 plays a role in UC pathogenesis or disease activity.

Main Methods:

Reviewed associations between UC and 85 AIP patients.
Performed IgG4 immunostaining on colonic biopsy specimens from 14 AIP and 32 UC patients.

Main Results:

Two AIP patients had confirmed UC.
Abundant IgG4-positive plasma cells were found in the colonic mucosa of one suspected type 2 AIP with UC case, two type 1 AIP cases without colitis, and 10 UC cases (31%).
IgG4-positive UC patients exhibited significantly higher moderate to severe disease activity compared to IgG4-absent patients.

Conclusions:

Ulcerative colitis is not considered a manifestation of IgG4-related disease, despite occasional associations with AIP.
The presence of IgG4-positive plasma cells in the colonic mucosa of UC patients is linked to increased disease activity.