Incidence of Malignancies in Patients with IgG4-related Disease

Kenji Hirano; Minoru Tada; Naoki Sasahira; Hiroyuki Isayama; Suguru Mizuno; Kaoru Takagi; Takeo Watanabe; Tomotaka Saito; Shuhei Kawahata; Rie Uchino; Tsuyoshi Hamada; Koji Miyabayashi; Dai Mohri; Takashi Sasaki; Hirofumi Kogure; Natsuyo Yamamoto; Yousuke Nakai; Haruhiko Yoshida; Yukiko Ito; Dai Akiyama; Nobuo Toda; Toshihiko Arizumi; Hiroshi Yagioka; Naminatsu Takahara; Saburo Matsubara; Yoko Yashima; Kazuhiko Koike

doi:10.2169/internalmedicine.53.1342

ORIGINAL ARTICLES

Incidence of Malignancies in Patients with IgG4-related Disease

Kenji Hirano, Minoru Tada, Naoki Sasahira, Hiroyuki Isayama, Suguru Mizuno, Kaoru Takagi, Takeo Watanabe, Tomotaka Saito, Shuhei Kawahata, Rie Uchino, Tsuyoshi Hamada, Koji Miyabayashi, Dai Mohri, Takashi Sasaki, Hirofumi Kogure, Natsuyo Yamamoto, Yousuke Nakai, Haruhiko Yoshida, Yukiko Ito, Dai Akiyama, Nobuo Toda, Toshihiko Arizumi, Hiroshi Yagioka, Naminatsu Takahara, Saburo Matsubara, Yoko Yashima, Kazuhiko Koike

Author information

Kenji Hirano
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Minoru Tada
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Naoki Sasahira
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Hiroyuki Isayama
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Suguru Mizuno
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Kaoru Takagi
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Takeo Watanabe
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Tomotaka Saito
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Shuhei Kawahata
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Rie Uchino
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Tsuyoshi Hamada
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Koji Miyabayashi
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Dai Mohri
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Takashi Sasaki
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Hirofumi Kogure
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Natsuyo Yamamoto
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Yousuke Nakai
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Haruhiko Yoshida
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan
Yukiko Ito
Department of Gastroenterology, Japanese Red Cross Medical Center, Japan
Dai Akiyama
Department of Gastroenterology, Japanese Red Cross Medical Center, Japan
Nobuo Toda
Department of Gastroenterology, Mitsui Memorial Hospital, Japan
Toshihiko Arizumi
Department of Gastroenterology, Mitsui Memorial Hospital, Japan
Hiroshi Yagioka
Department of Gastroenterology, JR Tokyo General Hospital, Japan
Naminatsu Takahara
Department of Gastroenterology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers,
Saburo Matsubara
Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Japan
Yoko Yashima
Department of Hepatology, Kyoundo Hospital, Japan
Kazuhiko Koike
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan

Keywords: IgG4-related disease, autoimmune pancreatitis, malignancy, diabetes mellitus

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 3 Pages 171-176

DOI https://doi.org/10.2169/internalmedicine.53.1342

Details

Abstract

Objective It has been discussed whether IgG4-related disease (IgG4-RD), including autoimmune pancreatitis (AIP), is associated with malignancy; however, the issue has not been clarified.
Methods We analyzed 113 patients with IgG4-RD in whom malignancy was not diagnosed at the time of IgG4-RD onset and the follow-up period was longer than six months. A total of 95 patients had AIP. The mean follow-up period was 73 months. The incidence of the observed malignancies was compared with the expected incidence in an age- and sex-matched general Japanese population based on the Vital Statistics of Japan.
Results There were 15 malignancies (lung cancer in five patients, pancreatic cancer in two patients, gastric cancer in two patients, bile duct cancer in one patient, renal cancer in one patient, breast cancer in one patient, tongue cancer in one patient, malignant melanoma in one patient and acute myeloid leukemia in one patient) in 14 patients during the follow-up period. The calculated standardized incidence rate of the total malignancies was not significant, that is, 1.04 (95% CI 0.57-1.75).
Conclusion The incidence of total malignancies in IgG4-RD patients is similar to that observed in the general population. At present, it is reasonable to conclude that IgG4-RD is not associated with an increased incidence of total malignancies.

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