Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2024; 12(33): 6608-6612
Published online Nov 26, 2024. doi: 10.12998/wjcc.v12.i33.6608
Journey to diagnosis: An unfinished exploration of IgG4-related sclerosing cholangitis
Ming-Xing Liang, Ya Chen, Ya He, Yi-Huai He
Ming-Xing Liang, Ya Chen, Ya He, Yi-Huai He, Department of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Author contributions: He YH, Liang MX, Chen Y and He Y contributed to this paper; He YH and Liang MX designed the overall concept and outline of the manuscript, contributed to the writing, and editing the manuscript, and review of literature; Chen Y and He Y contributed to the discussion and design of the manuscript.
Supported by The Science and Technology Research Foundation of Guizhou Province, and Zunyi City, No. QKHJC-ZK (2022) YB642, No. ZSKH·HZ (2022) 344, and No. gzwjkj2021-071; The WBE Liver Fibrosis Foundation, No. CFHPC2025028; and The Beijing Gandan Phase Mutual Public Welfare Fund for Artificial Liver Project, No. iGandanF-1082024-Rgg018.
Conflict-of-interest statement: The authors declare that they have no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Huai He, MD, Director, Department of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563000, Guizhou Province, China. 993565989@qq.com
Received: July 4, 2024
Revised: August 19, 2024
Accepted: August 23, 2024
Published online: November 26, 2024
Processing time: 84 Days and 15 Hours
Abstract

IgG4-related sclerosing cholangitis (IgG4-SC) is an inflammatory disease that leads to bile duct stricture, characterized by the infiltration of IgG4-positive plasma cells into the bile duct wall, thickening of the bile duct wall, and narrowing of the lumen. The differential diagnosis of IgG4-SC mainly includes primary sclerosing cholangitis, cholangiocarcinoma, and pancreatic cancer. IgG4-SC is often associated with autoimmune pancreatitis and can be accurately diagnosed based on clinical diagnostic criteria. However, isolated IgG4-SC is difficult to distinguish from biliary tumors. Given the significant differences in biological behavior, treatment, and prognosis between these diseases, accurately identifying isolated IgG4-SC has very important clinical significance.

Keywords: Isolated IgG4-associated sclerosing cholangitis; Cholangiocarcinoma; Autoimmune pancreatitis; IgG4-related diseases; Diagnosis and differential diagnosis

Core Tip: Isolated IgG4-related sclerosing cholangitis (IgG4-SC) shares similar clinical manifestations to bile duct tumors, yet they differ significantly in biological behavior, treatment, and prognosis. Therefore, an accurate diagnosis of isolated IgG4-SC is crucial for the clinical management of patients. This article will delve into the key diagnostic points, difficulties, and challenges of isolated IgG4-SC to aid in better identifying and managing this disease.