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JOP. 2005 May 10;6(3):269-73.

IgG4 negative sclerosing cholangitis associated with autoimmune pancreatitis.

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  • 1Department of Surgical Gastroenterology, Bhopal Memorial Hospital and Research Center, Bhopal, MP, India.

Abstract

BACKGROUND:

Sclerosing pancreatitis is an autoimmune condition characterized by periductal lymphocytic infiltration on histology, and elevated serum auto-antibodies and IgG4. Bile duct involvement is often associated with sclerosing pancreatitis but it is rarely the dominant feature.

CASE REPORT:

We report a patient with dominant biliary stricture and obstructive jaundice associated with IgG4 negative autoimmune pancreatitis. Due to uncertainties regarding the preoperative diagnosis, the patient underwent bilio-enteric bypass with an intraoperative pancreatic and bile duct biopsy. Post operatively, due to disease recurrence, the patient was started on steroids with consequent remission of the disease.

CONCLUSION:

Sclerosing pancreatitis may sometimes present with biliary stricture due to bile duct involvement due to the inflammatory process. The condition is often recognized after surgical exploration for a suspected malignancy. Preoperative diagnosis permits treatment with steroids and endoscopic biliary decompression, and avoids unnecessary surgery.

PMID:
15883479
[PubMed - indexed for MEDLINE]
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