Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2015; 21(31): 9448-9452
Published online Aug 21, 2015. doi: 10.3748/wjg.v21.i31.9448
Immunoglobulin G4-related autoimmune pancreatitis and sialadenitis: A case report
Ru-Ying Fan, Jian-Qiu Sheng
Ru-Ying Fan, Jian-Qiu Sheng, Department of Gastroenterology, Beijing Military General Hospital, Beijing 100700, China
Author contributions: Fan RY designed, wrote and revised the paper; Sheng JQ collected case data.
Institutional review board statement: The study was reviewed and approved by the Beijing Military General Hospital Institutional Review Board.
Informed consent statement: Study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ru-Ying Fan, MD, Department of Gastroenterology, Beijing Military General Hospital, No. 5 Nanmencang, Dongcheng District, Beijing 100700, China. fanry2@163.com
Telephone: +86-10-66721168 Fax: +86-10-66721629
Received: January 14, 2015
Peer-review started: January 16, 2015
First decision: April 13, 2015
Revised: April 27, 2015
Accepted: June 26, 2015
Article in press: June 26, 2015
Published online: August 21, 2015
Processing time: 217 Days and 17.3 Hours
Abstract

Immunoglobulin G4 (IgG4)-related disease is a rare systemic diseases. A 67-year-old male presented at our institution with mild upper abdominal pain and jaundice for 20 d. Laboratory results revealed high levels of IgG4 (15.4 g/L, range: 0.08-1.4 g/L). Computed tomography (CT) showed significant enlargement of the entire pancreas and a capsule-like low-density rim surrounding the whole pancreas. Positron emission tomography/CT revealed increased uneven metabolism of the entire pancreas. Both magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography showed stenosis of the distal common bile duct and proximal main pancreatic duct, and dilation of the proximal common bile duct and extra- and intra-hepatic bile ducts. He was diagnosed with IgG4-related autoimmune pancreatitis. The patient was treated with prednisone for 14 mo. The patient responded well to prednisone but upon cessation of the corticosteroid developed enlargement of the submandibular gland. The patient’s serum IgG4 was elevated at 23.9 g/L. It is important to maintain treatment, so the patient was again treated with prednisone and had a good response. Follow-up of IgG4-related disease is thus necessary.

Keywords: Immunoglobulin G4; Immunoglobulin G4-related disease; Autoimmune pancreatitis; Sialadenitis

Core tip: Immunoglobulin G4 (IgG4)-related disease is a rare systemic disease which affects many organs. Here we report a case of a patient with IgG4-related disease involving the pancreas and metachronous sialadenitis.