Clinical spectrum and management

Einar S. Björnsson, Keith D. Lindor

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

IgG4-related disease (IgG4-RD) is a relatively newly described disease entity. Autoimmune pancreatitis is its most widely recognized and best characterized manifestation. However, extrapancreatic lesions are common, such as cholangitis and retroperitoneal fibrosis. The term IgG4-related sclerosing cholangitis (IgG4-SC) biliary manifestation of IgG4-RD. Biliary strictures diagnosed and treated with steroids early in the course of IgG4-SC can resolve after successful therapy. This feature defines IgG4-SC which is histologically characterized by infiltration by IgG4-positive plasma cells. Though biliary strictures have been found to resolve with steroids, relapse is common. The long-term outcome is unclear. According to current guidelines, serum IgG4 levels should be measured in all patients with possible primary sclerosing cholangitis (PSC), to rule out IgG4-SC. PSC patients with elevated IgG4 levels seem to have a worse prognosis than those with normal IgG4 levels.

Original languageEnglish (US)
Title of host publicationAutoimmune (IgG4-Related) Pancreatitis and Cholangitis
PublisherSpringer New York
Pages171-179
Number of pages9
Volume9781441964304
ISBN (Electronic)9781441964304
ISBN (Print)1441964290, 9781441964298
DOIs
StatePublished - Feb 1 2013

ASJC Scopus subject areas

  • Medicine(all)

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