Title: Immunoglobulin G4-Related Disease (IgG4-RD) Presenting as Sclerosing Cholangitis - A Radiological Case Report

Authors: Kirti Rana Chaturvedy, Navjeet Kaur, Ramanand Gehlot, Preeti Meena

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.226

Abstract

Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic fibro-inflammatory disorder mimicking inflammatory and neoplastic processes. Numerous extrapancreatic organs such as the bile ducts, gallbladder, kidneys, retroperitoneum, thyroid, salivary glands, lung, mediastinum, lymph nodes, and prostate may be involved, either synchronously or metachronously. This case report of a 36 year old Indian male aims to highlight the imaging spectrum of multi-organ involvement in a case of IgG4 related disease. It is important to recognize multiorgan involvement of IgG4-related sclerosing disease and be familiar with its clinical and imaging features because it demonstrates a favourable response to treatment. Our case report leads us to reflect on the necessity to take into account this disease in patients with multisystem involvement.

Keywords: Immunoglobulin G4 related disease, sclerosing cholangitis, phlebitis, thrombosis, fibrosclerosing lesion.

References

  1. H. Stone, Y. Zen, and V. Deshpande, “IgG4-related disease,” The New England Journal of Medicine, vol. 366, no. 6, pp. 539–551, 2012.
  2. Cheuk and J. K. C. Chan, “IgG4-related sclerosing disease: a critical appraisal of an evolving clinicopathologic entity,” Advances in Anatomic Pathology, vol. 17, no. 5, pp. 303–332, 2010.
  3. Khosroshahi and J. H. Stone, “A clinical overview of IgG4-related systemic disease,” Current Opinion in Rheum-atology, vol.23, no. 1, pp. 57–66, 2011.
  4. Kawaguchi K, Koike M, Tsuruta K, Okamoto A, Tabata I, Fujita N. Lymphoplasmacytic sclerosing pancreatitis with cholangitis:a variant of primary sclerosing cholangitis extensively invol-ving pancreas. Hum Pathol1991;22:387-95
  5. Zen Y, Harada K, Sasaki M, Sato Y, Tsuneyama K, Haratake J, et al. IgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis? Am J Surg Pathol 2004;28: 1193-203.
  6. Deshpande V, Sainani NI, Chung RT, Pratt DS, Mentha G, Rubbia-Brandt L, et al. IgG4-associated cholangitis: a comparative histological and immunophenotypic study with primary sclerosing cholangitis on liver biopsy material. Mod Pathol 2009;22:1287-95.

Corresponding Author

Dr Navjeet Kaur

Resident, Dept of Radiodiagnosis,

Dr.Sampurnanand Medical College, Jodhpur, Rajasthan 342003

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.