Usefulness of Positron Emission Tomography in the Evaluation of Distribution and Activity of Systemic Lesions Associated with Autoimmune Pancreatitis

Matsubayashi, Hiroyuki; Furukawa, Hiroyoshi; Maeda, Atsuyuki; Matsunaga, Kazuya; Kanemoto, Hideyuki; Uesaka, Katsuhiko; Fukutomi, Akira; Ono, Hiroyuki

doi:10.1159/000199439

Cited by 73 publications

(66 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…FDG accumulation in AIP also appears at extrapancreatic sites, such as the lachrymal and salivary glands or the hilar lymph node. These features are useful for distinguishing between AIP and pancreatic cancer [32,103,104]. Another useful differentiating feature in AIP is a rapid decrease in FDG accumulation after corticosteroid therapy [104,105].…”

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

“…These features are useful for distinguishing between AIP and pancreatic cancer [32,103,104]. Another useful differentiating feature in AIP is a rapid decrease in FDG accumulation after corticosteroid therapy [104,105]. Description Although few studies have described EUS findings that may differentiate between AIP and pancreatic cancer or chronic pancreatitis, some findings that may be useful can be deduced from EUS or US studies of each disease [106][107][108][109][110].…”

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

See 1 more Smart Citation

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

et al. 2014

View full text Add to dashboard Cite

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

et al. 2014

View full text Add to dashboard Cite

“…Unlike autoimmune pancreatitis (AIP), the current case was not accompanied with elevated serum IgG4 or other organ involvement (4,23) despite the high level of serum IgG, IgG1, ANA and anti-DNA. In the case of AIP, the sensitivity of serum IgG4 is reported to be 90% (24) and an extrapancreatic lesion is depicted by FDG-PET in 85% (23).…”

Section: Discussionmentioning

confidence: 63%

“…In the case of AIP, the sensitivity of serum IgG4 is reported to be 90% (24) and an extrapancreatic lesion is depicted by FDG-PET in 85% (23). It was also interesting that current case was free from pancreatic involvement during the follow-up for more than a year without steroid therapy.…”

Section: Discussionmentioning

confidence: 65%

A Case of Sclerosing Cholangitis without Pancreatic Involvement Thought to be Associated with Autoimmunity

et al. 2011

Self Cite

View full text Add to dashboard Cite

Sclerosing cholangitis (SC) is one of the lesions frequently seen in IgG4-related systemic diseases, causing biliary stricture and mimicking bile duct carcinoma and primary sclerosing cholangitis (PSC). Although it often accompanies autoimmune pancreatitis (AIP), autoimmune-related SC without a pancreatic lesion is very rare. A 79-year-old woman was referred to our institution with suspected diagnosis of bile duct carcinoma in the previous hospital. The patient was not icteric and fever free, but with an elevated level of serum biliary enzyme, which lead us to detect this disease. Clinical images including computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP) and intraductal ultrasonography (IDUS) demonstrated multiple strictures at the intrahepatic bile duct and enhanced wall thickness at the upper common bile duct, however her pancreas was normal. Repeated endoscopic procedures with multiple biopsies from the biliary strictures demonstrated fibrous ductal tissues with lymph-plasma cell infiltration (>10 IgG4(+) cells/HPF). By positron emission tomography using 18 F-fluorodeoxyglucose (FDG-PET), the uptake of FDG was not remarkable in areas other than the biliary lesions. Additional laboratory tests showed elevated levels of serum IgG (2,571 mg/dL), and γ-globulin (29%), and positive autoantibodies, but normal IgG4 (53.2 mg/dL). Together with clinical images, laboratory and histological findings, we diagnosed this patient as sclerosing cholangitis which was thought to be associated with autoimmunity. After one year of follow-up without steroid therapy, idiopathic thrombocytopenic purpura (ITP) developed with an increased level of serological markers. We encountered a rare case of sclerosing cholangitis expected to be associated with autoimmunity, which showed biliary strictures mimicking bile duct carcinoma and needed careful diagnosis. Unlike the typical AIP, the current case demonstrated distinct serological findings and no other organ involvement. Further study is needed to clarify the characteristics of sclerosing cholangitis associated with autoimmunity with a large number of cases.

show abstract

“…3 Owing to confusion due to the use of various terms to describe the same condition, Japanese specialists reached a consensus to call this condition IgG4-RD, 2 a term confirmed internationally. 13 The comprehensive diagnostic criteria (CDC) for IgG4-RD 14 consist of three items: 1) diffuse or partial enlargement, swelling, nodules, or thickening lesions on single or multiple organs, 2) a serum IgG4 concentration > 135 mg/dL, and 3) histopathological findings including a) massive lymphocytic and plasmacytic infiltration and sclerosis, b) increased numbers of [18][19][20] (Fig. 1), and thus it is strongly recom- 23 is a type of IgG4-RD, whereas AIP type 2, also called idiopathic duct-centric pancreatitis or AIP with granulocytic epithelial lesions, 24,25 is a granulocytic lesion unrelated to IgG4.…”

Section: Diagnosis Of Systemic Igg4-rd By Comprehensive Diagnostic Crmentioning

confidence: 99%

IgG4-Related Disease: Diagnostic Methods and Therapeutic Strategies in Japan

Yasukawa

Shimizu

Nakamura

et al. 2014

J Clin Exp Hematopathol

View full text Add to dashboard Cite

This review describes methods utilized in Japan to diagnose and treat patients with IgG4-related disease. A diagnosis of IgG4-related disease is based on elevated serum IgG4 concentration and an increased number of IgG4 + plasma cells. Differentiating IgG4-related disease from other disorders, especially malignancy, is quite important. Consensus treatment in Japan consists of an initial dose of prednisolone at 0.5-0.6 mg/kg/day, followed by careful and gradual dose reduction. Most patients require maintenance treatment at 5 to 10 mg/day. Patients refractory to glucocorticoids are either truly refractory or have been misdiagnosed, therefore requiring reassessment. 〔J Clin Exp Hematop 54(2) : 95-101, 2014〕

show abstract

Usefulness of Positron Emission Tomography in the Evaluation of Distribution and Activity of Systemic Lesions Associated with Autoimmune Pancreatitis

Cited by 73 publications

References 37 publications

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

A Case of Sclerosing Cholangitis without Pancreatic Involvement Thought to be Associated with Autoimmunity

IgG4-Related Disease: Diagnostic Methods and Therapeutic Strategies in Japan

Contact Info

Product

Resources

About