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Pancreatobiliary
Review
Diagnosis and management of IgG4-related disease
  1. Vinod S Hegade1,
  2. Maria B Sheridan2,
  3. Matthew T Huggett1
  1. 1 Department of Gastroenterology, St James University Hospital, Leeds, UK
  2. 2 Department of Radiology, St James University Hospital, Leeds, UK
  1. Correspondence to Dr Vinod S Hegade, Department of Gastroenterology, St James University Hospital, Leeds LS9 7TF, UK; vinod.hegade{at}ncl.ac.uk

Abstract

IgG subclass 4-related disease (IgG4-RD) is a rare but increasingly recognised fibroinflammatory condition known to affect multiple organs. IgG4-RD is characterised by unique histological features of lymphoplasmacytic infiltration, storiform fibrosis and obliterative phlebitis. In this review we describe the pancreaticobiliary manifestations of IgG4-RD, with particular emphasis on type 1 autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-SC). AIP and IgG4-SC can pose diagnostic challenges to the clinician as they may mimic pancreatic cancer and primary sclerosing cholangitis, respectively. We discuss current knowledge, clinical diagnostic criteria and recent advances and summarise the evidence base for current therapeutic approaches for AIP and IgG4-SC.

  • pancreatitis
  • pancreatic pathology
  • pancreatic fibrosis
  • pancreatic disease
  • pancreas

https://doi.org/10.1136/flgastro-2018-101001

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    Footnotes

    • Contributors VSH drafted the main manuscript. MBS contributed in writing the radiology sections and images. MTH provided intellectual inputs and revised the draft. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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