{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:08:52Z","timestamp":1777039732049,"version":"3.51.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T00:00:00Z","timestamp":1645228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>\n                    The diagnosis of primary biliary cholangitis (PBC) in patients with seropositive anti\u2010mitochondrial antibody (AMA) but normal alkaline phosphatase (ALP) depends on a liver biopsy. We aimed to reveal potential serum biomarkers that could suggest the necessity of a liver biopsy in such patients. Retrospective analysis was performed. Subjects who were treatment naive with seropositive AMA but normal ALP and who underwent at least one liver biopsy between 2008 and 2020 were included in this study. Histologic biopsies were evaluated by two experienced pathologists blinded to the serum tests. A total of 115 patients who were treatment naive were included in this study. Of these, 77 patients (67%) exhibited histologic PBC features and nonspecific histologic features were found in the remaining 38 (33%) patients. Multivariate analysis suggested that baseline serum immunoglobulin M (IgM) &gt;0.773 \u00d7 upper limit of normal (ULN) (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001) and age &gt;42 years (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.002) were associated with the diagnosis of PBC through liver biopsies. A significant decrease in the median levels of gamma\u2010glutamyl transpeptidase (GGT) and IgM was found in 54 patients with PBC who received ursodeoxycholic acid (UDCA).\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    For patients who were treatment naive with seropositive AMA but normal ALP, baseline serum IgM &gt;0.773 \u00d7 ULN and age &gt;42 years were the factors that strongly suggested a diagnosis of PBC. In these patients receiving UDCA, a dynamic monitoring of GGT and IgM might be helpful in evaluating therapeutic responses.\n                  <\/jats:p>","DOI":"10.1002\/hep4.1907","type":"journal-article","created":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T03:33:50Z","timestamp":1645241630000},"page":"1403-1412","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Immunoglobulin M: A Neglected Serum Biomarker in Treatment\u2010Naive Primary Biliary Cholangitis With Normal Alkaline Phosphatase"],"prefix":"10.1097","volume":"6","author":[{"given":"Dawei","family":"Ding","sequence":"first","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoyun","family":"Xuan","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinan","family":"Hu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahao","family":"Yu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yansheng","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanya","family":"Guo","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuoyi","family":"Ma","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangfang","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi\u2019an,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyuan","family":"Tian","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer 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