%0 Journal Article
%T IgG4 Negative Sclerosing Cholangitis Associated with Autoimmune Pancreatitis
%A Sewkani A
%A Kapoor S
%A Sharma S
%A Naik S
%J JOP Journal of the Pancreas
%D 2005
%I E S Burioni Ricerche Bibliografiche
%X 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.
%K Adult
%K Autoimmune Diseases /complications/diagnosis/immunology/pathology
%K Cholangiopancreatography
%K Endoscopic Retrograde
%K Cholangitis
%K Sclerosing /complications/diagnosis/immunology/pathology
%K Humans
%K Immunoglobulin G /blood
%K Jaundice
%K Obstructive /complications/diagnosis/immunology/pathology
%K Jejunostomy
%K Male
%K Pancreatic Diseases
%K Pancreatitis /complications/diagnosis/immunology/pathology
%K Steroids /therapeutic use
%U http://www.joplink.net/prev/200505/03.html