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Diagnosis and Follow-up of IgG4-related Disease Involving the Bile Ducts and Pancreas by Using Magnetic Resonance Imaging: A Case Report
並列摘要
Immunoglobulin G4 (IgG4)-related disease involving the pancreas and bile ducts is an increasingly recognized syndrome, and serum IgG4 has been proposed as a biomarker for monitoring the disease activity and therapeutic response in most cases. However, there are few reports on the utility of magnetic resonance cholangiopancreatography (MRCP) as a marker of IgG4-related diseases, including its use in the disease activity and therapeutic response. We reported a 50-year-old woman presented with epigastralgia and obstructive jaundice. MRCP was not only suggestive of the diagnosis of autoimmune pancreatitis (AIP) but also showed progressively skipped stenotic lesions of the intrahepatic bile ducts. In addition, MRCP indicated reversible changes of the IgG4-related disease in the pancreas and bile ducts after steroid treatment, despite the serum IgG4 level remaining abnormally elevated. We herein suggest the importance of MRCP in the diagnosis of IgG4-related disease and in monitoring the effects of treatments.
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