Immunoglobulin G4-related disease: autoimmune pancreatitis and extrapancreatic manifestations

Fernandes, Daniel Alvarenga; Kido, Ricardo Yoshio Zanetti; Barros, Ricardo Hoelz de Oliveira; Martins, Daniel Lahan; Penachim, Thiago José; Caserta, Nelson Marcio Gomes

doi:10.1590/0100-3984.2013.1911

Cited by 4 publications

(2 citation statements)

References 10 publications

(23 reference statements)

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“…Previous studies have also found that a high proportion of cases of IgG4-RD present with abdominal pain (65%), jaundice (62%), and weight loss (42%) [ 14 ]. Although these clinical features may suggest a diagnosis of IgG4-RD, the diagnosis requires radiological and serological confirmation [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Type 1 Autoimmune Pancreatitis (AIP), a Form of IgG4-Related Disease (IgG4-RD)

et al. 2017

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Patient: Male, 70Final Diagnosis: IgG4 RDSymptoms: JaundiceMedication: —Clinical Procedure: —Specialty: Gastroenterology and HepatologyObjective:Rare diseaseBackground:Type 1 autoimmune pancreatitis (AIP), also known as lymphoplasmacytic sclerosing pancreatitis (LPSP), is a rare cause of chronic pancreatitis, characterized by a fibro-inflammatory process. However, patients with AIP may have a good response to corticosteroid therapy. We describe a Tunisian patient with AIP that was confirmed to be an IgG4-related disease (IgG4-RD).Case Report:We describe a case of a 70-year-old man who was admitted to hospital for obstructive jaundice and abdominal pain. Serum liver function tests were abnormal and upper abdominal computed tomography (CT) imaging showed diffuse pancreatic swelling and strictures of the main pancreatic duct without any focal lesion. Pancreatico-biliary magnetic resonance imaging (MRI) showed a thickened rim surrounding the pancreatic duct Serum IgG4 levels were elevated, resulting in a diagnosis of IgG4-related AIP. The patient showed a good clinical, biochemical, and radiological response following steroid therapy in combination with azathioprine.Conclusions:The diagnostic workup of IgG4-RD is complex and usually requires a combination of clinical examination, imaging, and serological analysis. As this case report has demonstrated, IgG4-RD should be considered in patients who present with pancreatitis or AIP, because of the favorable response to steroid therapy, particularly when treatment is initiated early.

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Section: Discussionmentioning

confidence: 99%

A Case of Type 1 Autoimmune Pancreatitis (AIP), a Form of IgG4-Related Disease (IgG4-RD)

et al. 2017

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“…Magnetic resonance imaging and, more often, computed tomography (CT) are the diagnostic imaging tools routinely used in the staging and therapeutic planning of cases of pancreatic disease ( 7 , 8 , 10 , 11 ) . For patients with PDAC, a multidisciplinary evaluation involving surgeons, oncologists, and radiologists, which is now routine, prevents many inappropriate practices.…”

Section: Introductionmentioning

confidence: 99%

Proposal for a structured computed tomography report in the evaluation of pancreatic neoplasms based on expert opinions

et al. 2018

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ObjectiveTo create a structured computed tomography (CT) report for the systematic evaluation of pancreatic ductal adenocarcinoma (PDAC), based on the opinions of clinicians and surgeons.Materials and MethodsThis was a prospective study in which we applied a 21-item questionnaire to experts in pancreatic diseases in order to create a model of a structured abdominal CT report. The questionnaire addressed the location and size of PDACs, as well as their effects on adjacent structures and on the vasculature, together with metastases. We used a Likert scale to determine which of those parameters should be included in the model.ResultsA total of 18 experts (12 surgeons and 6 clinicians) from 9 institutions completed the questionnaire. All of the experts agreed that the following (if present) should be described in the CT report on a PDAC: the degree of enhancement; the diameter and location of the lesion; pancreatic duct obstruction; biliary dilatation; pancreatic atrophy; liver metastases; peritoneal nodules; ascites; lymph node enlargement; and invasion of adjacent structures. More than 80% of the experts agreed that the report should also describe the relationship between the PDAC and the surrounding vasculature.ConclusionWe have developed a template for a CT report on patients with PDAC, based on the opinions of experts involved in the treatment of such patients.

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Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary Sjögren syndrome: results of an epidemiologic systematic review/meta-analysis and a consensus guideline from the Brazilian society of rheumatology (hepatic, gastrointestinal and pancreatic)

Trevisani

Pinheiro

Fialho³

et al. 2022

Adv Rheumatol

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Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, some systemic manifestations, mainly liver, gastrointestinal, and pancreatic are not routinely evaluated. To address these manifestations, the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology conducted a broad systematic review of the literature on studies investigating prevalence and diagnosis of these symptoms in Sjogren´s patients and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. This is the second part of this guideline, providing 6 recommendations for liver, gastrointestinal, and pancreatic care of SS patients.

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Immunoglobulin G4-related disease: autoimmune pancreatitis and extrapancreatic manifestations

Cited by 4 publications

References 10 publications

A Case of Type 1 Autoimmune Pancreatitis (AIP), a Form of IgG4-Related Disease (IgG4-RD)

A Case of Type 1 Autoimmune Pancreatitis (AIP), a Form of IgG4-Related Disease (IgG4-RD)

Proposal for a structured computed tomography report in the evaluation of pancreatic neoplasms based on expert opinions

Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary Sjögren syndrome: results of an epidemiologic systematic review/meta-analysis and a consensus guideline from the Brazilian society of rheumatology (hepatic, gastrointestinal and pancreatic)

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