title: Immunoglobulin G4 (IgG4)-associated pouchitis - Part of IgG4 related disease? A case series and review of the literature.
abstract: OBJECTIVE
  IgG4-mediated pouchitis was first described in 2011. The aetiology and pathogenesis of IgG4-associated pouchitis is unknown. Over the last four years, less than seventy cases of IgG-associated pouchitis have been reported from a pouchitis clinic in Cleveland.
  
  
  METHODS
  We report the first two cases of IgG4-associated pouchitis from our inflammatory bowel disease clinic and outside of Cleveland.
  
  
  CONCLUSIONS
  This highlights the fact that this entity could be more common than we think. It is important for general gastroenterologists to think about IgG4-mediated disease if the patient has refractory pouchitis, so early diagnosis and referral can be made. This would avoid the cost of expensive therapy and minimize antibiotic use which is what happened in our cases prior to this diagnosis being made.
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Allegheny General Hospital, Pittsburgh, PA, USA. Electronic address: mbilal@wpahs.org.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Bilal
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Allegheny General Hospital, Pittsburgh, PA, USA. Electronic address: agulati@wpahs.org.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Gulati
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Allegheny General Hospital, Pittsburgh, PA, USA. Electronic address: kclarke@wpahs.org.
authors.forename: Kofi
authors.initials: K
authors.lastname: Clarke
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000097:blood*; D003093:Colitis, Ulcerative / Q000150:complications*; D039021:Colonic Pouches / Q000473:pathology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000175:diagnosis* / Q000188:drug therapy; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012008:Recurrence
chemical_list: D000900:Anti-Bacterial Agents; D007074:Immunoglobulin G
keywords: Autoimmune; IgG4; Pouchitis