{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:09:51Z","timestamp":1780103391020,"version":"3.54.0"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,6,20]],"date-time":"2013-06-20T00:00:00Z","timestamp":1371686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ministry of Health Labor and Welfare, Japan"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2013,7]]},"abstract":"Abstract<\/jats:title>Background and Aim<\/jats:title>IgG<\/jats:styled-content>4\u2010related sclerosing cholangitis (IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content>) must be precisely distinguished from primary sclerosing cholangitis and cholangiocarcinoma (CC<\/jats:styled-content>) because the treatments are completely different. However, the pathological diagnosis of IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> is difficult. Therefore, highly specific non\u2010invasive criteria such as serum IgG<\/jats:styled-content>4 should be established. This study established a cut\u2010off for serum IgG<\/jats:styled-content>4 to differentiate IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> from respective controls using serum IgG<\/jats:styled-content>4 levels measured in J<\/jats:styled-content>apanese centers.<\/jats:p><\/jats:sec>Methods<\/jats:title>A total of 344 IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> patients were enrolled in this study. As controls, 245, 110, and 149 patients with pancreatic cancer, primary sclerosing cholangitis, and CC<\/jats:styled-content>, respectively, were enrolled. IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> patients were classified into three groups: type 1 (stenosis only in the lower part of the common bile duct), type 2 (stenosis diffusely distributed throughout the intrahepatic and extrahepatic bile ducts), and types 3 and 4 (stenosis in the hilar hepatic region) with 246, 56, and 42 patients, respectively. Serum IgG<\/jats:styled-content>4 levels were compared, and the cut\u2010offs were established.<\/jats:p><\/jats:sec>Results<\/jats:title>The cut\u2010off obtained from receiver operator characteristic curves showed similar sensitivity and specificity to that of 135\u2009mg\/dL<\/jats:styled-content> when all IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> and controls were compared. However, a new cut\u2010off value was established when subgroups of IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> and controls were compared. A cut\u2010off of 182\u2009mg\/dL<\/jats:styled-content> can increase the specificity to 96.6% (4.7% increase) for distinguishing types 3 and 4 IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> from CC<\/jats:styled-content>. A cut\u2010off of 207\u2009mg\/dL<\/jats:styled-content> might be useful for completely distinguishing types 3 and 4 IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> from all CC<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Serum IgG<\/jats:styled-content>4 is useful for the differential diagnosis of IgG<\/jats:styled-content>4\u2010SC<\/jats:styled-content> and controls.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.12248","type":"journal-article","created":{"date-parts":[[2013,4,26]],"date-time":"2013-04-26T12:08:46Z","timestamp":1366978126000},"page":"1247-1251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Establishment of a serum IgG<\/scp>4 cut\u2010off value for the differential diagnosis of IgG<\/scp>4\u2010related sclerosing cholangitis: A J<\/scp>apanese cohort"],"prefix":"10.1111","volume":"28","author":[{"given":"Hirotaka","family":"Ohara","sequence":"first","affiliation":[{"name":"Department of Community\u2010Based Medical Education Nagoya City University Graduate School of Medical Sciences Nagano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Nagano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeyuki","family":"Kawa","sequence":"additional","affiliation":[{"name":"Center for Health, Safety and Environmental Management Shinshu University Matsumoto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terumi","family":"Kamisawa","sequence":"additional","affiliation":[{"name":"Internal Medicine Tokyo Metropolitan Komagome Hospital 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