Immunoglobulin G4-related autoimmune hepatitis simultaneously concomitant with autoimmune pancreatitis: a case report

被引：3

作者：

Yokoyama, Yoshihiro ^{[1
,2
]}

Akutsu, Noriyuki ^{[2
]}

Numata, Yasunao ^{[2
]}

Okuda, Keiko ^{[1
]}

Morita, Rena ^{[3
]}

Masaki, Yoshiharu ^{[2
]}

Sasaki, Hajime ^{[1
]}

Suzuki, Ryo ^{[1
]}

Yabana, Takashi ^{[1
]}

Arimura, Yoshiaki ^{[1
]}

Kondo, Yoshihiro ^{[1
]}

Nakase, Hiroshi ^{[2
]}

机构：

[1] Otaru City Gen Hosp, Dept Gastroenterol, Otaru, Hokkaido, Japan

[2] Sapporo Med Univ, Dept Gastroenterol & Hepatol, Sch Med, Chuo Ku, S1W, Sapporo, Hokkaido 160608543, Japan

[3] Otaru City Gen Hosp, Dept Clin Pathol, Otaru, Hokkaido, Japan

来源：

CLINICAL JOURNAL OF GASTROENTEROLOGY | 2021年 / 14卷 / 06期

关键词：

IgG4-related autoimmune hepatitis; IgG4-related disease; Autoimmune pancreatitis; DIAGNOSIS; CRITERIA;

D O I：

10.1007/s12328-021-01509-0

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Thus far, there have been limited case reports on immunoglobulin G4-related autoimmune hepatitis (IgG4-AIH), and its clinical features have not been elucidated. We herein report a rare case of IgG4-AIH simultaneously concomitant with autoimmune pancreatitis (AIP). A 73-year-old female was admitted to our hospital for further investigation of elevated levels of liver transaminase and pancreatic enzymes. Her serological tests showed a high antinuclear antibody titer, and elevated IgG and IgG4 levels. Liver biopsy revealed interface hepatitis and bridging necrosis with IgG4-positive lymphoplasmacytic infiltration in the portal area. Moreover, contrast-enhanced computed tomography (CECT) showed pancreatic tail enlargement, and magnetic resonance cholangiopancreatography showed skipped narrowing of the main pancreatic duct in the pancreatic tail. Endoscopic ultrasonography-fine needle aspiration specimens showed no malignant cells. Based on these results, we diagnosed her with IgG4-AIH simultaneously concomitant with probable type 1 AIP. She was started on prednisolone (PSL) at 35 mg/d, and her symptoms and liver transaminase levels improved. One month after starting treatment, CECT showed improvement of pancreatic tail enlargement. She is maintained on 5 mg PSL/d and has been in remission for two years.

引用

页码：1740 / 1745

页数：6

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