Development of a scoring system for differentiating IgG4-related sclerosing cholangitis from primary sclerosing cholangitis
- Authors
- Moon, SH[Moon, Sung-Hoon]; Kim, MH[Kim, Myung-Hwan]; Lee, JK[Lee, Jong Kyun]; Baek, S[Baek, Seunghee]; Woo, YS[Woo, Young Sik]; Cho, DH[Cho, Dong Hui]; Oh, D[Oh, Dongwook]; Song, TJ[Song, Tae Jun]; Park, DH[Park, Do Hyun]; Lee, SS[Lee, Sang Soo]; Seo, DW[Seo, Dong Wan]; Lee, SK[Lee, Sung Koo]
- Issue Date
- Apr-2017
- Publisher
- SPRINGER JAPAN KK
- Keywords
- IgG4-related sclerosing cholangitis; Primary sclerosing cholangitis; Diagnosis; Scoring system
- Citation
- JOURNAL OF GASTROENTEROLOGY, v.52, no.4, pp.483 - 493
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF GASTROENTEROLOGY
- Volume
- 52
- Number
- 4
- Start Page
- 483
- End Page
- 493
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/29670
- DOI
- 10.1007/s00535-016-1246-5
- ISSN
- 0944-1174
- Abstract
- Background Recent research has shown that a substantial number of patients with primary sclerosing cholangitis (PSC) can also have elevated serum/tissue IgG4. The aim of our study was to develop a simple scoring system for the discrimination of IgG4-related sclerosing cholangits (IgG4-SC) from PSC. Methods Patients with IgG4-SC (n = 39) and PSC (n = 76) who had intrahepatic/hilar strictures were included. Candidate-differentiating variables included patient age, other organ involvement (OOI), inflammatory bowel disease, serum IgG4, and cholangiographic features. A scoring system was developed on the basis of these variables, and its performance was internally validated using a bootstrapping-based method. Results The scoring system in the final model included age (< 30 years, 0 points; 30-39 years, 1 point; 40-49 years, 2 points; 50-59 years, 3 points; ae<yen>60 years, 4 points), OOI (no, 0 points; yes, 3 points), and beaded appearance (yes, 0 points; no, 2 points). The patients were classified according to their total score into three categories: 0-4 points, probable PSC; 5-6 points, indicating diagnostic steroid trial; 7-9 points, probable IgG4-SC. The discrimination between IgG4-SC and PSC using the scoring system was excellent (area under the receiver operating characteristic curve, 0.986). Conclusion A reliable differentiation of IgG4-SC from PSC can be made using the scoring system presented here. We suggest the diagnosis of IgG4-SC at a cutoff of 7 points or higher and the indication of diagnostic steroid trial at 5 or 6 points. External validation of our scoring system is warranted.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - Medicine > Department of Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.