title: Rare case of Helicobacter pylori-positive multiorgan IgG4-related disease and gastric cancer.
abstract: A 61-year-old male from Northeast China presented with a 2-mo history of abdominal distension, pruritus and jaundice. Laboratory testing revealed an elevated serum IgG4 level. A computed tomography scan showed a typical feature of autoimmune pancreatitis (AIP) and cholecystocholangitis. Early gastric cancer was incidentally discovered when endoscopic untrasound-guided fine needle aspiration (EUS-FNA) of the pancreas was carried out. The patient underwent radical subtotal gastrectomy for gastric cancer combined with cholecystectomy. Helicobacter pylori (H. pylori) and IgG4-positive plasmacytes were detected in gastric cancer tissue, pancreatic EUS-FNA sample and resected gallbladder specimen by immunohistochemistry. The patient was diagnosed with H. pylori-positive IgG4-related AIP and sclerosing cholecystocholangitis as well as H. pylori-positive gastric cancer. He responded well to steroid therapy and remains healthy with no signs of recurrence at one year follow-up. We speculate that H. pylori might act as a trigger via direct or indirect action in the initiation of onset of gastric cancer and multiorgan IgG4-related disease.
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: Min
authors: M
authors: Li
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: Qiang
authors: Q
authors: Zhou
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: Kun
authors: K
authors: Yang
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: David R
authors: DR
authors: Brigstock
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: Lu
authors: L
authors: Zhang
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: Ming
authors: M
authors: Xiu
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: Li
authors: L
authors: Sun
authors: Min Li, Qiang Zhou, Kun Yang, Lu Zhang, Ming Xiu, Li Sun, Run-Ping Gao, Department of Hepatic-Biliary-Pancreatic Medicine, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
authors: Run-Ping
authors: RP
authors: Gao
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D002763:Cholecystectomy; D005743:Gastrectomy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D015415:Biomarkers; D007074:Immunoglobulin G; D054328:Proton Pump Inhibitors
keywords: Gastric cancer; Helicobacter pylori; IgG4-related disease; Sclerosing cholecystocholangitis; Type 1 autoimmune pancreatitis