{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:39:58Z","timestamp":1780544398846,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014382","name":"Ipsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014382","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>A proportion of patients with primary biliary cholangitis (PBC) have increased IgG (I\u2010IgG) levels at baseline, though not fulfilling the criteria of autoimmune hepatitis\/PBC variant. Our aim was to evaluate whether I\u2010IgG has prognostic significance in non\u2010cirrhotic PBC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of prospectively collected data from 675 PBC patients (592 non\u2010cirrhotic) with available IgG levels at first evaluation was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among non\u2010cirrhotic patients, 97 with I\u2010IgG were more frequently females (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), having a higher frequency of concurrent autoimmune diseases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and a higher frequency of PBC\u2010specific ANA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), sp100 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and gp210 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) compared to 495 with normal IgG (N\u2010IgG). Patients with I\u2010IgG were older (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and had lower albumin (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and higher AST (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), ALT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), ALP (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), \u03b3GT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) and IgM (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to those with N\u2010IgG. I\u2010IgG patients had a higher probability of cirrhosis development (Breslow\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05) and liver\u2010related death (Breslow\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) compared to N\u2010IgG patients. IgG &gt;\u20091.5xULN was the highest risk factor for cirrhosis development (HR\u2009=\u20099.507, 95% CI: 1.221\u201374.038,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032) and liver\u2010related death (HR\u2009=\u200927.140, 95% CI: 3.111\u2013236.783;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003); IgG normalisation after 1\u2009year of UDCA treatment had a favourable effect on disease outcome. \u039d\u2010IgG was associated with a higher probability of liver stiffness regression (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This long\u2010term study demonstrates that I\u2010IgG levels characterise a subgroup of non\u2010cirrhotic PBC patients with faster disease progression and increased probability of liver\u2010related death. Normalisation of IgG levels during UDCA treatment seems to improve prognosis and therefore, these patients could benefit from stricter follow\u2010up and earlier add\u2010on second\u2010line treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70074","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T09:33:53Z","timestamp":1742895233000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Increased\n                    <scp>IgG<\/scp>\n                    Levels at Diagnosis Are Associated With Worse Prognosis of Patients With Primary Biliary Cholangitis"],"prefix":"10.1111","volume":"45","author":[{"given":"Eirini I.","family":"Rigopoulou","sequence":"first","affiliation":[{"name":"Department of Medicine and Research Laboratory of Internal Medicine National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa  Larissa Greece"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER) General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassiliki","family":"Lygoura","sequence":"additional","affiliation":[{"name":"Department of Medicine and Research Laboratory of Internal Medicine National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa  Larissa Greece"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER) General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Gabeta","sequence":"additional","affiliation":[{"name":"Department of Medicine and Research Laboratory of Internal Medicine National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa  Larissa Greece"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER) General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Gatselis","sequence":"additional","affiliation":[{"name":"Department of Medicine and Research Laboratory of Internal Medicine National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa  Larissa Greece"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER) General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Giannoulis","sequence":"additional","affiliation":[{"name":"Department of Medicine and Research Laboratory of Internal Medicine National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7075-8464","authenticated-orcid":false,"given":"George N.","family":"Dalekos","sequence":"additional","affiliation":[{"name":"Department of Medicine and Research Laboratory of Internal Medicine National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa  Larissa Greece"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER) General University Hospital of Larissa  Larissa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.03.022"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280203"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.06.030"},{"issue":"6","key":"e_1_2_11_5_1","first-page":"623","article-title":"Revised Clinical Practice Guidelines of Autoimmune Hepatitis","volume":"37","author":"Dalekos G. 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