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Lancet. 2002 Apr 20;359(9315):1403-4.

Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis.

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Second Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Japan.


Sclerosing pancreatitis is associated with raised concentrations of IgG4. We treated 22 patients with sclerosing pancreatitis, and identified and followed-up three with concomitant hydronephrosis caused by ureteral mass, later diagnosed as retroperitoneal fibrosis. We histologically examined the ureteral and pancreatic lesions of these patients and noted abundant infiltration of IgG4-bearing plasma cells in both tissues. Treatment with corticosteroids lowered serum concentrations of IgG4. IgG4 might also have a pathological role in a systemic fibrosing process that includes pancreatic and retroperitoneal lesions.

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