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IgG4-related sclerosing cholangitis— A great mimicker

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Abstract

IgG4-related disease (IgG4 RD) is a multisystem disorder characterized by tumefactive (mass forming) lesions, storiform fibrosis, and IgG4-positive plasma cell infiltration. IgG4 sclerosing cholangitis (IgG4 SC) is the biliary manifestation of IgG4 RD, often in association with autoimmune pancreatitis (AIP). Here, we report two patients with IgG4-related cholangitis mimicking primary sclerosing cholangitis.

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References

  1. Kamisawa T, Egawa N, Nakajima H. Autoimmune pancreatitis is a systemic autoimmune disease. Am J Gastroenterol. 2003;98:2811–2.

    Article  Google Scholar 

  2. Kamisawa T, Funata N, Hayashi Y, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol. 2003;38:982–4.

    Article  CAS  Google Scholar 

  3. Rasch S, Phillip V, Schmid RM, Algül H. Epidemiology, clinical presentation, diagnosis and treatment of autoimmune pancreatitis: a retrospective analysis of 53 patients. Pancreatology. 2016;16:73–7.

    Article  Google Scholar 

  4. Rana SS, Gupta P, Sharma R, Bhatia A, Gupta R. A rare cause of reversible gastric outlet obstruction. Indian J Gastroenterol. 2018;37:469–71. 

    Article  Google Scholar 

  5. Tanaka A, Tazuma S, Okazaki K, et al. Clinical features, response to treatment, and outcomes of IgG4-related sclerosing cholangitis. Clin Gastroenterol Hepatol. 2017;15:920–6.

    Article  CAS  Google Scholar 

  6. Nakazawa T, Ohara H, Sano H, Ando T, Joh T. Schematic classification of sclerosing cholangitis with autoimmune pancreatitis by cholangiography. Pancreas. 2006;32:229. 

    Article  Google Scholar 

  7. Kamisawa T, Nakazawa T, Tazuma S, et al. Clinical practice guidelines for IgG4-related sclerosing cholangitis. J Hepatobiliary Pancreat Sci. 2019;26:9–42.

    Article  Google Scholar 

  8. Ghazale A, Chari ST, Zhang L, et al. Immunoglobulin G4-associatedcholangitis: clinical profile and response to therapy. Gastroenterology. 2008;134:706–15.

    Article  Google Scholar 

  9. Shimosegawa T, Chari ST, Frulloni L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas. 2011;40:352–8.

    Article  Google Scholar 

  10. Kawakami H, Zen Y, Kuwatani M, et al. IgG4-related sclerosing cholangitis and autoimmune pancreatitis: histological assessment of biopsies from Vater’s ampulla and the bile duct. J Gastroenterol Hepatol. 2010;25:1648–55.

    Article  Google Scholar 

  11. Rana SS, Gupta R, Nada R, et al. Clinical profile and treatment outcomes in autoimmune pancreatitis: a report from North India. Ann Gastroenterol. 2018;31(4):506–12.

    PubMed  PubMed Central  Google Scholar 

  12. Moon SH, Kim MH, Park DH, et al. IgG4 immunostaining of duodenal papillary biopsy specimens may be useful for supporting a diagnosis of autoimmune pancreatitis. Gastrointest Endosc. 2010;71:960–6.

    Article  Google Scholar 

  13. Moon SH, Kim MH, Park DH, et al. Presentation and management of post-treatment relapse in autoimmune pancreatitis immunoglobulin G4-associated cholangitis. Clin Gastroenterol Hepatol. 2009;7:1089–96.

    Article  Google Scholar 

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Correspondence to Subash Chandra Samal.

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HKN, SJB, MKP, IC, and SCS declare that they have no conflict of interest.

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The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Nayak, H.K., Bhat, S.J., Panigrahi, M.K. et al. IgG4-related sclerosing cholangitis— A great mimicker. Indian J Gastroenterol 39, 614–618 (2020). https://doi.org/10.1007/s12664-020-01102-2

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  • DOI: https://doi.org/10.1007/s12664-020-01102-2

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