title: Immunoglobulin G4-related autoimmune pancreatitis and sialadenitis: A case report.
abstract: Immunoglobulin G4 (IgG4)-related disease is a rare systemic diseases. A 67-year-old male presented at our institution with mild upper abdominal pain and jaundice for 20 d. Laboratory results revealed high levels of IgG4 (15.4 g/L, range: 0.08-1.4 g/L). Computed tomography (CT) showed significant enlargement of the entire pancreas and a capsule-like low-density rim surrounding the whole pancreas. Positron emission tomography/CT revealed increased uneven metabolism of the entire pancreas. Both magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography showed stenosis of the distal common bile duct and proximal main pancreatic duct, and dilation of the proximal common bile duct and extra- and intra-hepatic bile ducts. He was diagnosed with IgG4-related autoimmune pancreatitis. The patient was treated with prednisone for 14 mo. The patient responded well to prednisone but upon cessation of the corticosteroid developed enlargement of the submandibular gland. The patient's serum IgG4 was elevated at 23.9 g/L. It is important to maintain treatment, so the patient was again treated with prednisone and had a good response. Follow-up of IgG4-related disease is thus necessary.
authors: Ru-Ying Fan, Jian-Qiu Sheng, Department of Gastroenterology, Beijing Military General Hospital, Beijing 100700, China.
authors: Ru-Ying
authors: RY
authors: Fan
authors: Ru-Ying Fan, Jian-Qiu Sheng, Department of Gastroenterology, Beijing Military General Hospital, Beijing 100700, China.
authors: Jian-Qiu
authors: JQ
authors: Sheng
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011241:Prednisone / Q000627:therapeutic use; D012793:Sialadenitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D007074:Immunoglobulin G; D011241:Prednisone
keywords: Autoimmune pancreatitis; Immunoglobulin G4; Immunoglobulin G4-related disease; Sialadenitis