Biliary inflammation scoring for immunoglobulin G4-related sclerosing cholangitis: an endoscopic approach with endoscopic ultrasound

Feng, Yunlu; Zhang, Sheng‐Yu; Zheng, Zehui; Wu, Xi; Guo, Tao; Jiang, Qingwei; Wang, Qiang; Wu, Datong; Yang, Aiming

doi:10.1007/s00464-020-08222-y

Cited by 2 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…EUS is particularly versatile, as it not only assesses wall thickness and identifies intraluminal lesions but also detects pancreatic swelling associated with AIP and allows for tissue biopsy. Typical sonographic features of IgG4-SC include uniformly hypoechoic circumferential thickening of the duct wall and a smooth inner rim ( 35 ). Studies have indicated that a wall thickness of 0.8 mm in the non-stenotic segment of the bile duct under IDUS serves as an optimal cutoff value to differentiate IgG4-SC from cholangiocarcinoma, boasting a sensitivity and specificity of over 90% ( 36 ).…”

Section: Classification Of Igg4-dsdmentioning

confidence: 99%

IgG4-related digestive diseases: diagnosis and treatment

Wu,

Wang

2023

Front. Immunol.

View full text Add to dashboard Cite

IgG4-related digestive diseases encompass a group of chronic inflammatory disorders characterized by autoimmune reactions and fibrosis affecting multiple digestive organs. These diseases are identified by elevated serum levels of IgG4 and the presence of IgG4-positive plasma cell infiltration in the affected sites, along with storiform fibrosis, obliterative phlebitis, and eosinophilic infiltration. Although extensive research has been conducted, a comprehensive understanding of these conditions remains elusive. Current clinical diagnosis often relies on the application of integrated diagnostic criteria for IgG4-related diseases, combined with specific organ involvement criteria. Distinguishing them from malignancies poses considerable challenges. Moreover, further investigations are required to elucidate the underlying pathogenic mechanisms and explore potential therapeutic interventions. This review provides a systematic classification of IgG4-related digestive diseases while discussing their diagnostic strategies, clinical presentations, and treatment modalities. The comprehensive insights shared herein aim to guide clinicians in their practice and contribute to the advancement of knowledge in this field.

show abstract

Section: Classification Of Igg4-dsdmentioning

confidence: 99%

IgG4-related digestive diseases: diagnosis and treatment

Wu,

Wang

2023

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“… 18 , 19 , 20 Du et al 18 reported that the ability to observe the thickened wall (94.4% [17 of 18 patients]) was significantly more frequent in IgG4-SC cases compared to cholangiocarcinoma. Feng et al 20 proposed the biliary inflammation scoring method to distinguish IgG4-SC from cholangiocarcinoma. Using the scoring method, the sensitivity, specificity, and accuracy were 86%, 95%, and 90%, respectively.…”

Section: Endoscopic Ultrasoundmentioning

confidence: 99%

Diagnosing Biliary Strictures

Hori

Chari

Tsuji

et al. 2021

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

View full text Add to dashboard Cite

Biliary strictures caused by inflammation or fibrosis lead to jaundice and cholangitis which often make it difficult to distinguish malignant strictures. In cases when malignancy cannot be excluded, surgery is often performed. The concept of immunoglobulin G4 (IgG4)erelated sclerosing cholangitis (SC) as a benign biliary stricture was recently proposed. The high prevalence of the disease in Asian countries has resulted in multiple diagnostic and treatment guidelines; however, there is need to formulate a standardized diagnostic strategy among various countries considering the utility, invasiveness, and cost-effectiveness. We evaluated accuracies of various diagnostic modalities for biliary strictures comparing pathology in the Delphi meetings which were held in Rochester, MN. The diagnostic utility for each modality was graded according to the experts, including gastroenterologists, endoscopists, radiologists, and pathologists from the United States and Japan. Diagnostic utility of 10 modalities, including serum IgG4 level, noninvasive imaging, endoscopic ultrasound, endoscopic retrograde cholangiopancreatographyerelated diagnostic procedures were advocated and the reasons were specified. Serum IgG4 level, noninvasive imaging, diagnostic endoscopic ultrasound and intraductal ultrasonography under endoscopic retrograde cholangiopancreatography were recognized as useful modalities for the diagnosis. The information in this article will aid in the diagnosis of biliary strictures particularly for distinguishing IgG4eSC from cholangiocarcinoma and/or primary SC.

show abstract

Biliary inflammation scoring for immunoglobulin G4-related sclerosing cholangitis: an endoscopic approach with endoscopic ultrasound

Cited by 2 publications

References 19 publications

IgG4-related digestive diseases: diagnosis and treatment

IgG4-related digestive diseases: diagnosis and treatment

Diagnosing Biliary Strictures

Contact Info

Product

Resources

About