"Plasma Cell Hepatitis" in Liver Allografts: Identification and Characterization of an IgG4-Rich Cohort
Identifieur interne : 000468 ( France/Analysis ); précédent : 000467; suivant : 000469"Plasma Cell Hepatitis" in Liver Allografts: Identification and Characterization of an IgG4-Rich Cohort
Auteurs : M. Castillo-Rama [États-Unis] ; M. Sebagh [France] ; E. Sasatomi [États-Unis] ; P. Randhawa [États-Unis] ; K. Isse [États-Unis] ; A. D. Salgarkar [États-Unis] ; K. Ruppert [États-Unis] ; A. Humar [États-Unis] ; A. J. Demetris [États-Unis]Source :
- American journal of transplantation : (Print) [ 1600-6135 ] ; 2013.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Santé publique.
English descriptors
- KwdEn :
Abstract
Plasma cell hepatitis (PCH), also known as "de novo autoimmune" hepatitis, is an increasingly recognized, but suboptimally named and poorly understood, category of late allograft dysfunction strongly resembling autoimmune hepatitis (AIH): They share plasma-cell-rich necro-inflammatory activity on biopsy, auto-antibodies and steroid responsiveness, but overlap with rejection is problematic. A retrospective study of clinical, serological, histopathological and lgG4 immunohistological features of PCH (n = 20) in liver allograft recipients, native liver AIH (n = 19) and plasma-cell-rich renal allograft rejection (n = 20) showed: (1) high frequency (44%) of HLA-DR15; (2) less female predominance (p = 0.03) and (3) n = 9/20 PCH recipients showed >25 IgG4+ plasma cells/high-power field (lgG4+ PCH) versus AIH (n = 1/19, p = 0.008) or plasma-cell-rich kidney rejection (n = 2/20, p = 0.03). The IgG4+ PCH (n = 9) subgroup showed lower alanine transaminase (ALT) (p < 0.01) and aspartate transaminase (AST) (p < 0.05) at index biopsy but (a) higher plasma cell number/percentage, (b) more aggressive-appearing portal/periportal and perivenular necro-inflammatory activity and (c) more severe portal/periportal fibrosis than IgG4- PCH (n = 11). Significant demographic, histopathologic and plasma cell phenotype differences between PCH and AIH suggest distinct pathogenic mechanisms for at least the IgG4+ PCH subgroup likely representing an overlap between allo- and auto-immunity. IgG4+ PCH was associated with fibrosis, but also highly responsive to increased immunosuppression.
Affiliations:
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Castillo-Rama</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pathology, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Department of Pathology, Division of Liver and Transplantation Pathology, Thomas E Starzl Transplantation, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Sebagh, M" sort="Sebagh, M" uniqKey="Sebagh M" first="M." last="Sebagh">M. Sebagh</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Laboratoire d'Anatomie Pathologique, AP-HP Hôpital Paul Brousse</s1><s2>Villejuif</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>AP-HP Hôpital Paul Brousse</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Sasatomi, E" sort="Sasatomi, E" uniqKey="Sasatomi E" first="E." last="Sasatomi">E. Sasatomi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pathology, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Department of Pathology, Division of Liver and Transplantation Pathology, Thomas E Starzl Transplantation, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Randhawa, P" sort="Randhawa, P" uniqKey="Randhawa P" first="P." last="Randhawa">P. Randhawa</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pathology, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation></author><author><name sortKey="Isse, K" sort="Isse, K" uniqKey="Isse K" first="K." last="Isse">K. Isse</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pathology, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Department of Pathology, Division of Liver and Transplantation Pathology, Thomas E Starzl Transplantation, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Salgarkar, A D" sort="Salgarkar, A D" uniqKey="Salgarkar A" first="A. D." last="Salgarkar">A. D. Salgarkar</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pathology, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation></author><author><name sortKey="Ruppert, K" sort="Ruppert, K" uniqKey="Ruppert K" first="K." last="Ruppert">K. Ruppert</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Humar, A" sort="Humar, A" uniqKey="Humar A" first="A." last="Humar">A. Humar</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Surgery, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation></author><author><name sortKey="Demetris, A J" sort="Demetris, A J" uniqKey="Demetris A" first="A. J." last="Demetris">A. J. Demetris</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Pathology, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Department of Pathology, Division of Liver and Transplantation Pathology, Thomas E Starzl Transplantation, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author></analytic><series><title level="j" type="main">American journal of transplantation : (Print)</title><title level="j" type="abbreviated">Am. j. transplant. : (Print)</title><idno type="ISSN">1600-6135</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">American journal of transplantation : (Print)</title><title level="j" type="abbreviated">Am. j. transplant. : (Print)</title><idno type="ISSN">1600-6135</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Characterization</term><term>Cohort study</term><term>Corticosteroid</term><term>Fibrosis</term><term>Hepatitis</term><term>Homotransplantation</term><term>Identification</term><term>IgG4</term><term>Immunoglobulins</term><term>Immunosuppressive agent</term><term>Liver</term><term>Plasmocyte</term><term>Public health</term><term>Steroid</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Hépatite</term><term>Plasmocyte</term><term>Foie</term><term>Homotransplantation</term><term>Identification</term><term>Caractérisation</term><term>IgG4</term><term>Immunoglobuline</term><term>Etude cohorte</term><term>Santé publique</term><term>Fibrose</term><term>Stéroïde</term><term>Immunodépresseur</term><term>Corticostéroïde</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Santé publique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Plasma cell hepatitis (PCH), also known as "de novo autoimmune" hepatitis, is an increasingly recognized, but suboptimally named and poorly understood, category of late allograft dysfunction strongly resembling autoimmune hepatitis (AIH): They share plasma-cell-rich necro-inflammatory activity on biopsy, auto-antibodies and steroid responsiveness, but overlap with rejection is problematic. A retrospective study of clinical, serological, histopathological and lgG4 immunohistological features of PCH (n = 20) in liver allograft recipients, native liver AIH (n = 19) and plasma-cell-rich renal allograft rejection (n = 20) showed: (1) high frequency (44%) of HLA-DR15; (2) less female predominance (p = 0.03) and (3) n = 9/20 PCH recipients showed >25 IgG4+ plasma cells/high-power field (lgG4+ PCH) versus AIH (n = 1/19, p = 0.008) or plasma-cell-rich kidney rejection (n = 2/20, p = 0.03). The IgG4+ PCH (n = 9) subgroup showed lower alanine transaminase (ALT) (p < 0.01) and aspartate transaminase (AST) (p < 0.05) at index biopsy but (a) higher plasma cell number/percentage, (b) more aggressive-appearing portal/periportal and perivenular necro-inflammatory activity and (c) more severe portal/periportal fibrosis than IgG4- PCH (n = 11). Significant demographic, histopathologic and plasma cell phenotype differences between PCH and AIH suggest distinct pathogenic mechanisms for at least the IgG4+ PCH subgroup likely representing an overlap between allo- and auto-immunity. IgG4+ PCH was associated with fibrosis, but also highly responsive to increased immunosuppression.</div></front></TEI><affiliations><list><country><li>France</li><li>États-Unis</li></country><region><li>Pennsylvanie</li></region><settlement><li>Pittsburgh</li></settlement><orgName><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><noRegion><name sortKey="Castillo Rama, M" sort="Castillo Rama, M" uniqKey="Castillo Rama M" first="M." last="Castillo-Rama">M. Castillo-Rama</name></noRegion><name sortKey="Castillo Rama, M" sort="Castillo Rama, M" uniqKey="Castillo Rama M" first="M." last="Castillo-Rama">M. Castillo-Rama</name><name sortKey="Demetris, A J" sort="Demetris, A J" uniqKey="Demetris A" first="A. J." last="Demetris">A. J. Demetris</name><name sortKey="Demetris, A J" sort="Demetris, A J" uniqKey="Demetris A" first="A. J." last="Demetris">A. J. Demetris</name><name sortKey="Humar, A" sort="Humar, A" uniqKey="Humar A" first="A." last="Humar">A. Humar</name><name sortKey="Isse, K" sort="Isse, K" uniqKey="Isse K" first="K." last="Isse">K. Isse</name><name sortKey="Isse, K" sort="Isse, K" uniqKey="Isse K" first="K." last="Isse">K. Isse</name><name sortKey="Randhawa, P" sort="Randhawa, P" uniqKey="Randhawa P" first="P." last="Randhawa">P. Randhawa</name><name sortKey="Ruppert, K" sort="Ruppert, K" uniqKey="Ruppert K" first="K." last="Ruppert">K. Ruppert</name><name sortKey="Salgarkar, A D" sort="Salgarkar, A D" uniqKey="Salgarkar A" first="A. D." last="Salgarkar">A. D. Salgarkar</name><name sortKey="Sasatomi, E" sort="Sasatomi, E" uniqKey="Sasatomi E" first="E." last="Sasatomi">E. Sasatomi</name><name sortKey="Sasatomi, E" sort="Sasatomi, E" uniqKey="Sasatomi E" first="E." last="Sasatomi">E. Sasatomi</name></country><country name="France"><noRegion><name sortKey="Sebagh, M" sort="Sebagh, M" uniqKey="Sebagh M" first="M." last="Sebagh">M. Sebagh</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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