Sequential Evaluation of Pancreato-Biliary Findings in a Case with IgG4-Associated Cholangiopathy and Autoimmune Pancreatitis during Corticosteroid Treatment.
BACKGROUND
Immunoglobulin G4 (IgG4)-associated diseases mostly involve the pancreaticobiliary tree and pancreatic parenchyma. This disease complex is characterized by marked response to corticosteroid therapy and response to steroids is incorporated in the diagnostic algorithm of IgG4 associated diseases. However, there is much unknown about the sequences and duration of healing during the corticosteroid therapy in the literature.


METHODS
In this case report, we report a young male patient with IgG4 associated extrahepatic biliary stricture and autoimmune pancreatitis successfully treated with corticosteroids. Recovery in the laboratory and radiological findings seemed to correlate well with the decrease in serum IgG4 levels in this patient. We also discussed sequences and the duration of healing in the pancreaticobiliary tree and pancreatic parenchymal manifestations in this case report.


CONCLUSIONS
There is a gap in our knowledge about the evaluation of response criteria after steroid trial with regard to the duration and sequences of healing in the pancreaticobiliary involvement in diagnosing IgG4-related biliary and pancreatic diseases.
Department of Radiology, Bülent Ecevit University School of Medicine, Zonguldak, Turkey.
İsmail
İ
Şerifoğlu
Department of Radiology, Bülent Ecevit University School of Medicine, Zonguldak, Turkey.
İbrahim İlker
İİ
Öz
Department of Gastroenterology, Bülent Ecevit University School of Medicine, Zonguldak, Turkey.
Yücel
Y
Üstündağ
Department of Internal Medicine, Bülent Ecevit University School of Medicine, Zonguldak, Turkey.
Sevil Uygun
SU
İlikhan
Department of Radiology, Antalya Training and Research Hospital, Antalya, Turkey.
Özlem
Ö
Tokgöz
Autoimmune pancreatitis; IgG4; IgG4 associated diseases; corticosteroid; imaging