Usefulness of steroid administration for diagnosis of IgG4-related sclerosing cholangitis.
Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is one of the IgG4-related systemic sclerosing diseases and responds well to steroid therapy. A 58-year-old male was admitted with hilar bile duct stenosis revealed by computed tomography. We performed percutaneous transhepatic right portal vein embolization (PTPE) and scheduled a right hepatectomy because a hilar cholangiocarcinoma was first suspected. However, there was no cytologic evidence of malignancy and serum IgG4 was elevated. Steroid therapy was initiated after PTPE. There was no evidence of bile duct stenosis after 4 weeks. Improving diagnostic technique, IgG4-SC was diagnosed and treated with steroid therapy. In some cases, we couldn't deny the malignancy and performed unnecessary resection. We recommend that steroid administration while waiting for the liver volume to increase after PTPE is useful. The therapy aids in the diagnosis of bile duct stenosis, which has value for a hilar bile duct limit type of IgG4-SC, as in the case reported here.
Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan.
Norio
N
Kubo
Hideki
H
Suzuki
Tsutomu
T
Kobayashi
Kenichiro
K
Araki
Shigeru
S
Sasaki
Wataru
W
Wada
Hiroyuki
H
Kuwano
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D007074:Immunoglobulin G; D011239:Prednisolone