Abstract
Background. Inflammatory bowel disease (IBD) is a global problem today, with a growing prevalence in the world. It significantly increases the economic burden on the health care system. Recently, many studies indicate the important role of immunoglobulin G4 (IgG4) in the formation of chronic inflammation in IBD and the possibility of using it as a biomarker of the inflammatory process. The purpose was to improve the diagnosis of chronic inflammatory bowel diseases by studying the status of IgG4-positive plasma cells in the mucous membrane of the colon in patients with ulcerative colitis (UC) and Crohn’s disease (CD). Materials and methods. We have examined 34 patients with IBD, 25 with UC and 9 with CD, of them 20 women and 14 men, with an average age of (38.8 ± 3.0) and (38.2 ± 3.7) years, respectively. Patients were divided into groups depending on the nosology and severity of the disease. All patients underwent endoscopic examination of the colon to establish or clarify the diagnosis, and biopsy specimens were taken for histological and immunohistochemical examination. Results. In 13 (38.3%) of 34 examined patients, a positive result for the presence of tissue IgG4 (≥ 10 cells in the field of view) was found. Among patients with UC, 48% have a positive result of immunohistochemical examination of tissue IgG4, in people with CD, this figure is 11.1%. This gives us reason to say that in UC, elevation of tissue IgG4 levels occurs 4.4 times more often. Positive tissue IgG4 in patients with moderate UC was found 1.1 times more often than in severe UC. Among patients with mildly active disease, tissue IgG4 was not detected. Conclusions. In UC, IgG4-positive cells in the mucous layer of the colon are more common than in CD, which makes it possible to use this indicator for the differential diagnosis of ulcerative colitis and Crohn’s disease. Positive tissue IgG4 is more common in moderate form than in severe one.
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