Pulmonary involvement of autoimmune pancreatitis
Pulmonary involvement of autoimmune pancreatitis
复制标题
DOI：
10.1111/j.1365-2362.2009.02164.x
复制
发表时间：
2009-08-01
影响因子：
5.5
通讯作者：
Kubo, K.
中科院分区：
文献类型：
--
作者：
Tsushima, K.;Tanabe, T.;Kubo, K.
背景自身免疫性胰腺炎患者的全身病变多种多样.分析了自身免疫性胰腺炎的肺部受累，以阐明肺部病变的临床病理特征，比较肺结节病.Materials和Methods 19例自身免疫性胰腺炎和8例肺结节病。症状，实验室数据，胸部CT，镓-67造影，肺功能检测和支气管镜检查结果，包括组织学IgG 4-免疫染色和IgG亚类在支气管肺泡灌洗液中的自身免疫性胰腺炎，收集比较它们与肺结节病。在自身免疫性胰腺炎中，17名患者显示双侧肺门淋巴结肿大，而8名患者在胸部计算机断层扫描上显示肺结节。19例患者中有18例在镓-67造影中显示肺门或纵隔淋巴结中的积聚点。6例肺结节患者在胸部CT上显示相应病灶内的聚集点。8例肺结节病患者均表现为肺门或纵隔淋巴结内的聚集点。自身免疫性胰腺炎支气管肺泡灌洗液IgG 4与肺结节病相比显著增加。结论自身免疫性胰腺炎患者支气管肺泡灌洗液中IgG 4水平明显升高，肺组织中可见IgG 4阳性浆细胞。
P>BackgroundA wide variety of systemic lesions have been seen in patients with autoimmune pancreatitis. The pulmonary involvement of autoimmune pancreatitis was analysed to clarify the clinicopathological features of pulmonary lesions in comparison with pulmonary sarcoidosis.Materials and methodsNineteen patients had autoimmune pancreatitis and eight had pulmonary sarcoidosis. The symptoms, laboratory data, chest computed tomography, Gallium-67 scintigraphy, pulmonary function testing and bronchoscopy findings, including the histological IgG4-immunostaining and IgG subclasses in the bronchoalveolar lavage in autoimmune pancreatitis, were collected to compare them with pulmonary sarcoidosis.ResultsThe serum total protein, IgG and IgG4 levels were found to be significantly elevated in comparison with pulmonary sarcoidosis. In autoimmune pancreatitis, 17 patients showed bilateral hilar lymphadenopathy, while eight showed pulmonary nodules on chest computed tomography. Eighteen of 19 patients on Gallium-67 scintigraphy showed accumulation spots in either the hilar or mediastinal lymph nodes. Six patients with pulmonary nodules demonstrated accumulation spots in the corresponding lesions on chest computed tomography. All eight patients with pulmonary sarcoidosis showed accumulation spots in either the hilar or mediastinal lymph nodes. Bronchoalveolar lavage IgG4 in autoimmune pancreatitis showed a significant increase in comparison with pulmonary sarcoidosis. The histological findings obtained by a transbronchial lung biopsy showed the infiltration of lymphocytes and plasma cells in the thickened interstitum and alveoli with IgG4-positive plasma cell infiltration in patients with autoimmune pancreatitis.ConclusionIgG4 in the bronchoalveolar lavage was seen at remarkably increased levels and IgG4-positive plasma cells were identified in the pulmonary lesions of patients with autoimmune pancreatitis.