IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis

IgG4-related disease is a relatively novel clinical entity whose gastrointestinal manifestations include type 1 autoimmune pancreatitis (AIP) and IgG4-associated sclerosing cholangitis. The presence of elevated serum IgG4 is suggestive but not essential for the diagnosis of type 1 AIP and is a perva...

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Main Authors: Allon Kahn, Anitha D. Yadav, M. Edwyn Harrison
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Gastrointestinal Medicine
Online Access:http://dx.doi.org/10.1155/2015/591360
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author Allon Kahn
Anitha D. Yadav
M. Edwyn Harrison
author_facet Allon Kahn
Anitha D. Yadav
M. Edwyn Harrison
author_sort Allon Kahn
collection DOAJ
description IgG4-related disease is a relatively novel clinical entity whose gastrointestinal manifestations include type 1 autoimmune pancreatitis (AIP) and IgG4-associated sclerosing cholangitis. The presence of elevated serum IgG4 is suggestive but not essential for the diagnosis of type 1 AIP and is a pervasive feature of the proposed diagnostic criteria. The differential diagnosis of type 1 AIP includes malignant conditions, emphasizing the importance of a deliberate, comprehensive evaluation. Management of patients with a suggestive clinical presentation, but without serum IgG4 elevation, is difficult. Here we present three cases of IgG4-seronegative AIP and sclerosing cholangitis that responded to empiric steroid therapy and discuss approach considerations. These cases demonstrate the value of meticulous application of existing diagnostic algorithms to achieve a clinical diagnosis and avoid surgical intervention.
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series Case Reports in Gastrointestinal Medicine
spelling doaj-art-0de34e9816b34353b691e0da77e8de7a2025-08-20T03:55:33ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362015-01-01201510.1155/2015/591360591360IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing CholangitisAllon Kahn0Anitha D. Yadav1M. Edwyn Harrison2Department of Medicine, Mayo Clinic, Scottsdale, AZ, USADivision of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USADivision of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USAIgG4-related disease is a relatively novel clinical entity whose gastrointestinal manifestations include type 1 autoimmune pancreatitis (AIP) and IgG4-associated sclerosing cholangitis. The presence of elevated serum IgG4 is suggestive but not essential for the diagnosis of type 1 AIP and is a pervasive feature of the proposed diagnostic criteria. The differential diagnosis of type 1 AIP includes malignant conditions, emphasizing the importance of a deliberate, comprehensive evaluation. Management of patients with a suggestive clinical presentation, but without serum IgG4 elevation, is difficult. Here we present three cases of IgG4-seronegative AIP and sclerosing cholangitis that responded to empiric steroid therapy and discuss approach considerations. These cases demonstrate the value of meticulous application of existing diagnostic algorithms to achieve a clinical diagnosis and avoid surgical intervention.http://dx.doi.org/10.1155/2015/591360
spellingShingle Allon Kahn
Anitha D. Yadav
M. Edwyn Harrison
IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis
Case Reports in Gastrointestinal Medicine
title IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis
title_full IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis
title_fullStr IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis
title_full_unstemmed IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis
title_short IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis
title_sort igg4 seronegative autoimmune pancreatitis and sclerosing cholangitis
url http://dx.doi.org/10.1155/2015/591360
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AT anithadyadav igg4seronegativeautoimmunepancreatitisandsclerosingcholangitis
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