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IgG4相关性硬化性胆管炎：并非总是一种明显的疾病。

IgG4-related sclerosing cholangitis: not always an obvious entity.

作者信息

Velegraki Magdalini, Vardas Emmanouil, Dervenis Christos, Fragaki Maria, Nikolaou Pinelopi, Mpitouli Afroditi, Kazamias George, Sepsa Athanasia, Giannikaki Elpida, Paspatis Gregorios A

机构信息

Department of Gastroenterology, Venizeleion General Hospital, Heraklion (Magdalini Velegraki, Emmanouil Vardas, Maria Fragaki, Pinelopi Nikolaou, Afroditi Mpitouli, Gregorios A. Paspatis).

Hepatobiliary and Pancreatic Surgery Clinic, Metropolitan Hospital, Athens (Christos Dervenis).

出版信息

Ann Gastroenterol. 2021 Jul-Aug;34(4):594-596. doi: 10.20524/aog.2021.0610. Epub 2021 Feb 26.

DOI:10.20524/aog.2021.0610
PMID:34276201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8276355/
Abstract

Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is a distinct type of cholangitis, currently recognized as a biliary manifestation of IgG4-related disease. We present a case of type 3 IgG4-SC in a patient with normal IgG4 serum levels, surgically treated for suspicion of cholangiocarcinoma. This case highlights that differentiating between isolated IgG4-SC and cholangiocarcinoma can present a challenging diagnostic dilemma.

摘要

免疫球蛋白G4相关性硬化性胆管炎（IgG4-SC）是一种独特类型的胆管炎，目前被认为是IgG4相关性疾病的一种胆道表现。我们报告一例血清IgG4水平正常的3型IgG4-SC患者，因怀疑胆管癌接受了手术治疗。该病例突出表明，鉴别孤立性IgG4-SC和胆管癌可能会带来具有挑战性的诊断难题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4e/8276355/74cbc89e7e56/AnnGastroenterol-34-594-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4e/8276355/e4d2a4cfa064/AnnGastroenterol-34-594-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4e/8276355/99a32a94b675/AnnGastroenterol-34-594-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4e/8276355/74cbc89e7e56/AnnGastroenterol-34-594-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4e/8276355/e4d2a4cfa064/AnnGastroenterol-34-594-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4e/8276355/99a32a94b675/AnnGastroenterol-34-594-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4e/8276355/74cbc89e7e56/AnnGastroenterol-34-594-g003.jpg

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本文引用的文献

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Digital, single-operator cholangiopancreatoscopy in the diagnosis and management of pancreatobiliary disorders: a multicenter clinical experience (with video).数字单操作胆管胰管镜在胰胆疾病的诊断和治疗中的应用：一项多中心临床经验（附视频）。
Gastrointest Endosc. 2016 Oct;84(4):649-55. doi: 10.1016/j.gie.2016.03.789. Epub 2016 Mar 16.
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IgG4-related disease.IgG4 相关疾病。
Lancet. 2015 Apr 11;385(9976):1460-71. doi: 10.1016/S0140-6736(14)60720-0. Epub 2014 Dec 4.
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Isolated IgG4-related sclerosing cholangitis: a report of 9 cases.
孤立性 IgG4 相关硬化性胆管炎：9 例报告。
Hum Pathol. 2014 Aug;45(8):1722-9. doi: 10.1016/j.humpath.2014.04.006. Epub 2014 Apr 24.
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Establishment of a serum IgG4 cut-off value for the differential diagnosis of IgG4-related sclerosing cholangitis: a Japanese cohort.建立用于鉴别诊断 IgG4 相关硬化性胆管炎的血清 IgG4 截断值：一项日本队列研究。
J Gastroenterol Hepatol. 2013 Jul;28(7):1247-51. doi: 10.1111/jgh.12248.
5
Clinical diagnostic criteria of IgG4-related sclerosing cholangitis 2012.2012 年 IgG4 相关硬化性胆管炎的临床诊断标准
J Hepatobiliary Pancreat Sci. 2012 Sep;19(5):536-42. doi: 10.1007/s00534-012-0521-y.
6
Consensus statement on the pathology of IgG4-related disease.关于 IgG4 相关疾病病理学的共识声明。
Mod Pathol. 2012 Sep;25(9):1181-92. doi: 10.1038/modpathol.2012.72. Epub 2012 May 18.
7
Diagnostic criteria for IgG4-related sclerosing cholangitis based on cholangiographic classification.基于胆管造影分类的 IgG4 相关硬化性胆管炎的诊断标准。
J Gastroenterol. 2012 Jan;47(1):79-87. doi: 10.1007/s00535-011-0465-z. Epub 2011 Sep 23.
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J Gastroenterol. 2011 May;46(5):696-704. doi: 10.1007/s00535-010-0361-y. Epub 2010 Dec 25.
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