IgG4-negative autoimmune pancreatitis with sclerosing cholangitis and colitis: possible association with primary sclerosing cholangitis?
We report a case of autoimmune pancreatitis (AIP) with cholangiography and histopathology showing features characteristic of primary sclerosing cholangitis (PSC) and colitis. A 55-year-old previously-healthy man was diagnosed with anti-nuclear antibody (ANA)-positive AIP according to the finding of serum biochemistry, abdominal US (ultrasonography), CT (computed tomography) and ERCP (endoscopic retrograde cholangiopancreatography). However, bead-like strictures of intrahepatic bile ducts were also found and liver tissue showed onion skin-like periductal fibrosis but no anti-IgG4-positive cells. In addition, colon fiberscopy showed a pancolitis similar to ulcerative colitis indicating that, in this case, there may be an association with PSC. Here, we report a rare case of IgG4-negative AIP with sclerosing cholangitis and colitis with many clinical features that support an association with PSC.
Saeki
Keita
K
Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine, Tokyo.
Hozawa
Shigenari
S
Miyata
Naoteru
N
Nishizawa
Toshihiro
T
Soma
Hiromitsu
H
Iwao
Yasushi
Y
Kameyama
Kaori
K
Hibi
Toshifumi
T
D000284:Administration, Oral; D000974:Antibodies, Antinuclear / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000473:pathology*; D003092:Colitis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000188:drug therapy; D013256:Steroids / Q000008:administration & dosage
D000974:Antibodies, Antinuclear; D007074:Immunoglobulin G; D013256:Steroids