Diagnostic utility of IgG and IgM immunohistochemistry in autoimmune liver disease.

Moreira RK, Revetta F, Koehler E, Washington MK
World J Gastroenterol. 2010 16 (4): 453-7

PMID: 20101770 · PMCID: PMC2811797 · DOI:10.3748/wjg.v16.i4.453

AIM - To assess the role of IgM and IgG immunohistochemistry (IHC) in the evaluation of autoimmune liver conditions--autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC).

METHODS - Forty one biopsies from untreated patients diagnosed with autoimmune liver disease (AIH, n = 20; PBC, n = 13; PSC, n = 8) and fourteen biopsies of patients with chronic hepatitis C were selected. IgM and IgG-positive plasma cells were counted in each sample.

RESULTS - A predominance of IgG-positive plasma cells was seen in AIH (90% of cases), PSC (75% of cases), and chronic hepatitis C (100% of cases), while IgM-positive plasma cells predominated in PBC (92.8% of cases). The IgM /IgG ratio (< 1 or > or = 1) accurately distinguished PBC from AIH in 90.9% of cases (sensitivity = 92.3%, specificity = 90%), and PBC from either AIH or PSC in 87.8% of cases (sensitivity = 92.3%, specificity = 85.7%).

CONCLUSION - Plasmacytic infiltrates expressing predominantly IgM are characteristic of PBC, while other forms of liver disease analyzed in this study, including AIH, typically show an IgG-predominant plasma cell infiltrate. Our data indicate that IgM and IgG IHC may be a useful tool when PBC is a diagnostic consideration.

MeSH Terms (19)

Adolescent Adult Aged Biopsy Child Child, Preschool Cholangitis, Sclerosing Female Hepatitis, Autoimmune Humans Immunoglobulin G Immunoglobulin M Immunohistochemistry Liver Liver Cirrhosis, Biliary Male Middle Aged Plasma Cells Young Adult

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