We read with great interest the article by Hubers et al published in Gut.1 They identified annexin A11 as an autoantigen in IgG4-associated cholangitis (IAC) and autoimmune pancreatitis (AIP), which is targeted by IgG4 and IgG1 antibodies in the sera of IAC/AIP patients.1 Notably, they reported that none of the 20 patients tested for primary sclerosing cholangitis (PSC) had anti-annexin A11 antibodies. Thus, the measurement of these antibodies is helpful in differentiating IAC from PSC. In addition to the anti-annexin A11 antibodies, we recently reported another autoantibody, anti-laminin 511-E8 antibody, in patients with AIP.2 Here, we show a case of IAC/AIP with a normal serum IgG4 concentration and no infiltration of IgG4 plasma cells in the biliary duct, whose diagnosis was made by measuring the anti-laminin 511-E8 antibody.
A 57-year-old man visited our hospital in 2005 for swelling of pancreas. Contrast-enhanced CT and magnetic resonance cholangiopancreatography suggested focal AIP, showing a mass in the pancreatic body...
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