Usefulness of ultrasonography to assess the response to steroidal therapy for the rare case of type 2b immunoglobulin G4-related sclerosing cholangitis without pancreatitis:A case report  

作　　者：Yuto Tanaka Kenya Kamimura Ryota Nakamura Marina Ohkoshi-Yamada Yohei Koseki Takeshi Mizusawa Satoshi Ikarashi Kazunao Hayashi Hiroki Sato Akira Sakamaki Junji Yokoyama Shuji Terai 

机构地区：[1]Division of Gastroenterology and Hepatology,Graduate School of Medical and Dental Sciences,Niigata University,Niigata 9518510,Japan

出　　处：《World Journal of Clinical Cases》2020年第22期5821-5830,共10页世界临床病例杂志

摘　　要：BACKGROUND A type 2b immunoglobulin G4(IgG4)-related sclerosing cholangitis(SC)without autoimmune pancreatitis is a rare condition with IgG4-SC.While the variety of the imaging modalities have tested its usefulness in diagnosing the IgG4-SC,however,the usage of ultrasonography for the assessment of the response to steroidal therapy on the changes of bile duct wall thickness have not been reported in the condition.Therefore,the information of our recent case and reported cases have been summarized.CASE SUMMARY We report the case of an 82-year-old Japanese man diagnosed with isolated IgG4-related SC based on the increase of serum IgG4,narrowing of the bile duct,its wall thickness,no complication of autoimmune pancreatitis,and IgG4 positive inflammatory cell infiltration to the wall with the fibrotic changes.The cholangiogram revealed type 2b according to the classification.Corticosteroid treatment showed a favorable effect,with the smooth decrease in serum IgG4 and the improvement of the bile duct wall thickness.CONCLUSION As isolated type 2b,IgG4-SC is rare,the images,histological findings,and clinical course of our case will be helpful for physicians to diagnose and treat the new cases appropriately.

关 键 词：Immunoglobulin G4-related sclerosing cholangitis Type 2b CORTICOSTEROID Autoimmune pancreatitis ULTRASONOGRAPHY Imaging Case report 

分 类 号：R575.7[医药卫生—消化系统]