Usefulness of ultrasonography to assess the response to steroidal therapy for the rare case of type 2b immunoglobulin G4-related sclerosing cholangitis without pancreatitis: A case report
| Autor: | Junji Yokoyama, Takeshi Mizusawa, Kenya Kamimura, Satoshi Ikarashi, Yuto Tanaka, Ryota Nakamura, Yohei Koseki, Kazunao Hayashi, Akira Sakamaki, Marina Ohkoshi-Yamada, Hiroki Sato, Shuji Terai |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Gastroenterology Imaging 03 medical and health sciences 0302 clinical medicine Immunoglobulin g4 Internal medicine parasitic diseases Case report Rare case medicine Corticosteroid skin and connective tissue diseases Autoimmune pancreatitis Ultrasonography biology business.industry fungi Immunoglobulin G4-related sclerosing cholangitis General Medicine medicine.disease 030220 oncology & carcinogenesis biology.protein Pancreatitis 030211 gastroenterology & hepatology Antibody business Type 2b |
| Zdroj: | World Journal of Clinical Cases |
| ISSN: | 2307-8960 |
| DOI: | 10.12998/wjcc.v8.i22.5821 |
| Popis: | BACKGROUND A type 2b immunoglobulin G4 (IgG4)-related sclerosing cholangitis (SC) without autoimmune pancreatitis is a rare condition with IgG4-SC. While the variety of the imaging modalities have tested its usefulness in diagnosing the IgG4-SC, however, the usage of ultrasonography for the assessment of the response to steroidal therapy on the changes of bile duct wall thickness have not been reported in the condition. Therefore, the information of our recent case and reported cases have been summarized. CASE SUMMARY We report the case of an 82-year-old Japanese man diagnosed with isolated IgG4-related SC based on the increase of serum IgG4, narrowing of the bile duct, its wall thickness, no complication of autoimmune pancreatitis, and IgG4 positive inflammatory cell infiltration to the wall with the fibrotic changes. The cholangiogram revealed type 2b according to the classification. Corticosteroid treatment showed a favorable effect, with the smooth decrease in serum IgG4 and the improvement of the bile duct wall thickness. CONCLUSION As isolated type 2b, IgG4-SC is rare, the images, histological findings, and clinical course of our case will be helpful for physicians to diagnose and treat the new cases appropriately. |
| Databáze: | OpenAIRE |
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