{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:43:02Z","timestamp":1785307382508,"version":"3.55.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Primary biliary cholangitis (PBC) and autoimmune hepatitis (AIH) can be difficult to distinguish in end-stage liver disease. Previous studies have shown that immunoglobulin G (IgG) and immunoglobulin M (IgM) immunostaining can differentiate AIH from PBC in needle core biopsy specimens, and we seek to extend these data to cirrhotic liver explants, in which the histology of AIH or PBC may be indiscernible.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Clinical data were reviewed for 20 patients with PBC cirrhosis and 16 with AIH cirrhosis. Immunohistochemistry for IgM and IgG was performed on representative blocks of explanted livers. Three high-power fields with the highest concentration of IgG- and IgM-positive plasma cells were counted and compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The average number of IgM-positive plasma cells was significantly higher in PBC explants (7.3) than in AIH (1.8) (P = .001). There was no significant difference in the average number of IgG-positive plasma cells in PBC (2.5) and AIH (2.8) (P = .8). The IgG\/IgM ratio was more likely to be less than 1.0 in PBC (17\/20, 85%) compared with AIH (7\/16, 44%) (P = .01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our study demonstrates that the absolute number of IgM plasma cells is greater in explants of cirrhotic PBC compared with AIH. These findings may be helpful in the evaluation of cryptogenic cirrhosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqac101","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T17:48:35Z","timestamp":1662054515000},"page":"770-773","source":"Crossref","is-referenced-by-count":5,"title":["IgG and IgM Immunohistochemistry in Primary Biliary Cholangitis (PBC) and Autoimmune Hepatitis (AIH) Liver Explants"],"prefix":"10.1093","volume":"158","author":[{"given":"Maylee","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington Medical Center , Seattle, WA , USA"},{"name":"Department of Pathology, Veterans Affairs Medical Center , Portland, OR , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9078-3832","authenticated-orcid":false,"given":"Jennifer Y","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington Medical Center , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith M","family":"Pearson","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington Medical Center , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington Medical Center , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul E","family":"Swanson","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington Medical Center , Seattle, WA , USA"},{"name":"Department of Medicine, University of Washington Medical Center , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington Medical Center , Seattle, WA , USA"},{"name":"Department of Medicine, University of Washington Medical Center , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"2022120107125054200_CIT0001","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1038\/modpathol.3800684","article-title":"Autoimmune liver disease: overlap and outliers","volume":"20","author":"Washington","year":"2007","journal-title":"Mod Pathol."},{"key":"2022120107125054200_CIT0002","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.4254\/wjh.v8.i28.1157","article-title":"Cirrhosis and autoimmune liver disease: current understanding","volume":"8","author":"Liberal","year":"2016","journal-title":"World J Hepatol."},{"key":"2022120107125054200_CIT0003","doi-asserted-by":"crossref","first-page":"609","DOI":"10.3389\/fimmu.2018.00609","article-title":"Autoantibodies in autoimmune liver disease\u2014clinical and diagnostic relevance","volume":"9","author":"Sebode","year":"2018","journal-title":"Front Immunol."},{"key":"2022120107125054200_CIT0004","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1309\/AJCP8WHR0IEVUUOJ","article-title":"Immunostaining of plasma cells in primary biliary cirrhosis","volume":"131","author":"Daniels","year":"2009","journal-title":"Am J Clin Pathol."},{"key":"2022120107125054200_CIT0005","doi-asserted-by":"crossref","first-page":"453","DOI":"10.3748\/wjg.v16.i4.453","article-title":"Diagnostic utility of IgG and IgM immunohistochemistry in autoimmune liver disease","volume":"16","author":"Moreira","year":"2010","journal-title":"World J Gastroenterol."},{"key":"2022120107125054200_CIT0006","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.cgh.2019.11.024","article-title":"IgG:IgM ratios of liver plasma cells reveal similar phenotypes of primary biliary cholangitis with and without features of autoimmune hepatitis","volume":"19","author":"Lee","year":"2021","journal-title":"Clin Gastroenterol Hepatol."},{"key":"2022120107125054200_CIT0007","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.dld.2009.12.006","article-title":"Intrahepatic IgG\/IgM plasma cells ratio helps in classifying autoimmune liver diseases","volume":"42","author":"Cabibi","year":"2010","journal-title":"Dig Liver Dis."},{"key":"2022120107125054200_CIT0008","doi-asserted-by":"crossref","first-page":"3597","DOI":"10.3748\/wjg.v20.i13.3597","article-title":"Clinicopathological study of primary biliary cirrhosis with interface hepatitis compared to autoimmune hepatitis","volume":"20","author":"Kobayashi","year":"2014","journal-title":"World J Gastroenterol."},{"key":"2022120107125054200_CIT0009","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1309\/AJCPE93GZSHUNTAI","article-title":"The usefulness of IgG and IgM immunostaining of periportal inflammatory cells (plasma cells and lymphocytes) for the distinction of autoimmune hepatitis and primary biliary cirrhosis and their staining pattern in autoimmune hepatitis-primary biliary cirrhosis overlap syndrome","volume":"133","author":"Lee","year":"2010","journal-title":"Am J Clin Pathol."},{"key":"2022120107125054200_CIT0010","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1309\/AJCPCE4IZTNA4SSZ","article-title":"Immunohistochemical staining of inflammatory cells in liver biopsy specimens of patients with autoimmune hepatitis, primary biliary cirrhosis, and overlap syndromes","volume":"134","author":"Moreira","year":"2010","journal-title":"Am J Clin Pathol."},{"key":"2022120107125054200_CIT0011","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1002\/hep.24630","article-title":"Immunoglobulin M levels inversely correlate with CD40 ligand promoter methylation in patients with primary biliary cirrhosis","volume":"55","author":"Lleo","year":"2012","journal-title":"Hepatology."},{"key":"2022120107125054200_CIT0012","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S0168-8278(99)80098-1","article-title":"Clinical and biochemical expression of the histopathological lesions of primary biliary cirrhosis","volume":"30","author":"Poupon","year":"1999","journal-title":"J Hepatol."}],"container-title":["American Journal of Clinical 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