NEW-ONSET JAUNDICE IN A PATIENT WITH HISTORY OF RETROPERITONEAL FIBROSIS, A CASE REPORT

作者：Foti Pietro Valerio^*; Attina Giancarlo; Cappello Giuseppina; Palmucci Stefano; Romeo Carmelo Salvatore; Giglio Angelita; Berretta Salvatore; Milone Pietro; Ettorre Giovanni Carlo

来源：Acta Medica Mediterranea, 2015, 31(5): 1099-1103.

• IgG4-related sclerosing cholangitis
• retroperitoneal fibrosis
• primary sclerosing cholangitis
• cholangiocarcinoma
• magnetic resonance imaging

Introduction: We describe a case of IgG4-related sclerosing cholangitis (IgG4-SC). IgG4-SC is the biliary manifestation of a recently defined clinicopathological entity, named IgG4-related disease (IgG4-RD).
Case presentation: A 52-year-old woman with history of retroperitoneal fibrosis was admitted to our hospital for further evaluation of new-onset jaundice. Laboratory investigations revealed a rise of cholestasis indexes. Magnetic resonance (MR) examination revealed intra-hepatic bile duct dilatation and biliary stricture at the hepatic hilum, without pancreatic involvement. Corticosteroid treatment lead to an improvement of patients clinical condition and decrease of cholestasis indexes.
Conclusion: The differential diagnosis between IgG4-SC, primary sclerosing. cholangitis (PSC) and cholangiocarcinoma (CCA) is very important because of the different therapeutic approach. The diagnosis of IgG4-related sclerosing disease should be considered in patients with sclerosing cholangitis, especially when it is associated with other fibroinflammatory disorder, to avoid unnecessary surgery.

• 出版日期2015