Immunoglobulin G4-Seronegative Autoimmune Cholangiopathy With Pancreatic and Hepatic Involvement Mimicking as Primary Sclerosing Cholangitis.

Autor:	Achalu S; Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City, CA., Berry R; Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City, CA., Wei MT; Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City, CA., Banerjee S; Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City, CA., Ghanouni P; Department of Radiology, Stanford University School of Medicine, Palo Alto, CA., Kambham N; Department of Pathology, Stanford University School of Medicine, Palo Alto, CA., Kwo PY; Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City, CA.
Jazyk:	angličtina
Zdroj:	ACG case reports journal [ACG Case Rep J] 2023 Apr 20; Vol. 10 (4), pp. e01044. Date of Electronic Publication: 2023 Apr 20 (Print Publication: 2023).
DOI:	10.14309/crj.0000000000001044
Abstrakt:	Immunoglobulin G4-seronegative autoimmune cholangiopathy is a rare cause of biliary strictures. We describe a 27-year-old man presenting with elevated liver enzymes, recurrent cholangitis/bacteremia, biliary strictures, and normal immunoglobulin G4 levels, who was initially diagnosed with primary sclerosing cholangitis, and later listed for transplantation for recurrent bacteremia. Subsequent surveillance imaging demonstrated morphologic changes consistent with biliary strictures and autoimmune pancreatitis. Initiating corticosteroids resulted in liver enzyme normalization and stricture improvement. Diagnosing seronegative autoimmune cholangiopathy remains challenging given similar presentation to primary sclerosing cholangitis. This case highlights importance of a wide differential for biliary strictures, with increased suspicion in those developing pancreatic changes in this setting. (© 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
Databáze:	MEDLINE
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