Diagnostic procedures for IgG4-related sclerosing cholangitis

Abstract

Background/purpose IgG4-related sclerosing cholangitis (IgG4-

IgG4-related sclerosing cholangitis: liver biopsy findings

“…Clinically, PSC usually occurs in younger patients and presents with obstructive jaundice more commonly than IgG4-SC. PSC is commonly associated with inflammatory bowel disease, whereas IgG4-SC is associated with autoimmune pancreatitis 3. The measurement of serum IgG4 levels is useful for differentiating between these two disorders; according to previous studies, increased serum IgG4 levels exceeding 135 mg/dL are frequently seen in these patients 4…”

IgG4 Sclerosing Cholangitis and Post Infantile Giant Cell Hepatitis: A Case Report of an Extraordinary Co-presentation

“…Some authors have stated that combined histological findings and positive immunostaining are not enough to diagnose IgG4-SC [18]. Therefore, other diagnostic tools as serum markers and radiologic studies are essential, not only for IAC diagnosis, but also for ruling out the possibility of cholangiocarcinoma, especially in patients' presenting with hilar cholangiopathy [19]. ERCP had displayed superior results over the less invasive MRCP in recognition of early or single large duct PSC.…”

Diagnostic Dilemma in a Patient with Jaundice: How to Differentiate between Autoimmune Pancreatitis, Primary Sclerosing Cholangitis and Pancreas Carcinoma

“…It is at present known and accepted that immunoglobulin G4 (IgG4)-associated cholangitis (IAC) is one of several diseases associated with autoimmune pancreatitis (AIP) [1, 2, 3]. However, IAC may occur in 20–90% of cases of AIP whereas a study of the Mayo Clinic recently revealed that 92.5% of patients with IAC suffer from AIP [4, 5, 6].…”

“…A possible involvement of Helicobacter pylori in the initiation of the autoimmune process is speculated [7, 8, 9]. Typical results concerning blood values are high IgG4 concentrations, which can be seen as a useful indicator to differentiate between other pancreatic or bile duct diseases [1, 2, 3, 4, 10]. IgG4-related diseases such as AIP and IAC have typical histopathological features in common showing a diffuse infiltration with lymphocytes and IgG4-positive plasma cells [1, 2, 4, 7, 10].…”