title: Hepatobiliary Iminodiacetic Acid Scanning Detects High-Grade Biliary Obstruction Secondary to IgG4-Related Sclerosing Cholangitis.
abstract: In this report, we present a case of high-grade biliary obstruction discovered on hepatobiliary scintigraphy secondary to IgG4-related sclerosing cholangitis with concomitant autoimmune pancreatitis, a recently described entity that is gaining recognition in the radiology literature. To our knowledge, the scintigraphic findings have yet to be described in the literature. We present the hepatobiliary scintigraphic findings and their correlation to findings on endoscopic retrograde cholangiopancreatography, CT, and MR cholangiopancreatography, with posttreatment follow-up imaging. IgG4-related sclerosing cholangitis is a rare yet important diagnostic consideration when high-grade obstruction is seen on hepatobiliary iminodiacetic acid scanning. We discuss the differential diagnosis of high-grade biliary obstruction seen on hepatobiliary iminodiacetic acid scanning.
authors: Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, Beaumont Health System, Royal Oak, Michigan sayf.al-katib@beaumont.edu.
authors: Sayf
authors: S
authors: Al-Katib
authors: Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, Beaumont Health System, Royal Oak, Michigan.
authors: Zaid
authors: Z
authors: Al-Faham
authors: Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, Beaumont Health System, Royal Oak, Michigan.
authors: Farnoosh
authors: F
authors: Sokhandon
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications; D015209:Cholangitis, Sclerosing / Q000150:complications*; D002779:Cholestasis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007098:Imino Acids; D007074:Immunoglobulin G / Q000378:metabolism*; D008297:Male; D010195:Pancreatitis / Q000150:complications; D011877:Radionuclide Imaging
chemical_list: D007098:Imino Acids; D007074:Immunoglobulin G; C008109:iminodiacetic acid
keywords: HIDA scan; IgG4-related sclerosing cholangitis; autoimmune pancreatitis; biliary obstruction