[一例合并胰腺分裂症的IgG4相关性硬化性胆管炎病例]

[A case of IgG4-related sclerosing cholangitis with pancreas divisum].

作者信息

Hamada Yasuhiko, Inoue Hiroyuki, Noda Tomohiro, Aoki Masatoshi, Katsurahara Masaki, Kosaka Ryo, Tanaka Kyosuke, Imoto Ichiro, Isaji Shuji, Takei Yoshiyuki

机构信息

Department of Gastroenterology and Hepatology, Mie Medical School of Medicine.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2010 Jul;107(7):1184-91.

PMID:20616487

Abstract

We report an extremely rare case of IgG4-related sclerosing cholangitis with pancreas divisum. A 62-year-old man presented to our hospital with obstructive jaundice and hilar bile duct stenosis. An inflammatory tumor was suspected due to elevated of blood IgG4 levels. Endoscopic retrograde cholangiopancreatography revealed hilar bile duct stenosis and pancreas divisum. The biopsy specimens obtained by endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) revealed inflammatory findings. Steroid hormone therapy at an initial dose of 30mg/day resulted in dramatic improvement of the bile duct stenosis and blood chemistry data.

摘要

我们报告了一例极其罕见的伴有胰腺分裂的IgG4相关性硬化性胆管炎病例。一名62岁男性因梗阻性黄疸和肝门部胆管狭窄前来我院就诊。由于血液IgG4水平升高，怀疑为炎性肿瘤。内镜逆行胰胆管造影显示肝门部胆管狭窄和胰腺分裂。通过内镜超声引导下细针穿刺活检（EUS-FNAB）获得的活检标本显示有炎症表现。初始剂量为每日30mg的类固醇激素治疗使胆管狭窄和血液生化指标得到显著改善。