{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T12:09:26Z","timestamp":1778933366033,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Chang Gung Medical Research Program"},{"DOI":"10.13039\/501100001868","name":"national science council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The phenotype of immunoglobulin G4 (IgG4)-related cholangitis (IRC) patients among type 1 autoimmune pancreatitis (AIP-1) patients in Taiwan, where secondary biliary cholangitis is prevalent, is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the phenotype of IRC in AIP-1 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A 15-year cohort study of 237 AIP-1 patients was conducted. AIP-1 was diagnosed according to the HISORt criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 237 AIP-1 patients, 90 (37.9%) had IRC (males:\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200980 (88.9%); type 1 IRC:\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200980 (88.8%); mean age: 65.63\u2009years). Among AIP-1 patients, those with IRC had higher alanine aminotransferase (ALT) (179.4\u2009\u00b1\u2009202.6 vs 118.0\u2009\u00b1\u2009167.8\u2009U\/L,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.014), alkaline phosphatase (ALP) (322.5\u2009\u00b1\u2009239.1 vs 201.4\u2009\u00b1\u2009193.7\u2009U\/L,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), total bilirubin (bili-T) (5.69\u2009\u00b1\u20095.28 vs 2.95\u2009\u00b1\u20094.19\u2009mg\/dL,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and IgG4 (1271.9\u2009\u00b1\u20091256.3 vs 904.0\u2009\u00b1\u2009811.4\u2009mg\/dL,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.015) levels and a borderline higher cumulative incidence of mortality (14.4 vs 7.5%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.068) than those without IRC did. Moreover, baseline bili-T levels (odds ratio (OR): 1.194,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.031) (cutoff: &gt;2.2\u2009mg\/dL) were independently associated with IRC. Among AIP-1 patients, baseline ALP (OR: 1.004,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001), fibrosis-4 index (OR: 1.156,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.025), cirrhosis (OR: 23.157,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and neutrophil-to-lymphocyte ratio (NLR) (OR: 1.103,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.008) were associated with mortality. Among the IRC-AIP-1 patients, baseline ALP levels (OR: 1.002,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.028) and NLR (OR: 1.091,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012) were associated with mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In total, 37.9% of AIP-1 patients had IRC. Higher levels of hepatocellular injury, cholestatic features, and IgG4 were noted in patients with IRC than in patients without IRC. Baseline bili-T level (cutoff\u2009&gt;\u20092.2\u2009mg\/dL) is an indicator of IRC among AIP-1 patients. Biliary injury and systemic inflammation are associated with mortality in all AIP-1 and IRC-AIP-1 patients. Liver fibrosis subsequent to IRC might further increase mortality in AIP-1 patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848261447198","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T11:18:28Z","timestamp":1778498308000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Jaundice marks immunoglobulin G4-related cholangitis in type 1 autoimmune pancreatitis patients"],"prefix":"10.1177","volume":"19","author":[{"given":"Chi-Huan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan"},{"name":"Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai-Feng","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan"},{"name":"Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Guei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan"},{"name":"Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Chiang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology, Chang Gung Memorial Hospital at Linko, Chang Gung University, College of Medicine, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung-Lin","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Branch, 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