Overlap of IgG4-related Sclerosing Cholangitis and Primary Biliary Cirrhosis
We herein present a case of an overlap of immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) and primary biliary cirrhosis (PBC). A 61-year-old man was diagnosed with PBC due to abnormal liver biochemical tests and positivity for serum anti-M2 antibody. However, his response to bezafibrate a...
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Veröffentlicht in: | Internal Medicine 2014, Vol.53(13), pp.1429-1433 |
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container_title | Internal Medicine |
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creator | Takemoto, Reika Miyake, Yasuhiro Harada, Kenichi Nakanuma, Yasuni Moriya, Akio Ando, Masaharu Hirohata, Mamoru Yamamoto, Kazuhide |
description | We herein present a case of an overlap of immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) and primary biliary cirrhosis (PBC). A 61-year-old man was diagnosed with PBC due to abnormal liver biochemical tests and positivity for serum anti-M2 antibody. However, his response to bezafibrate and ursodeoxycholic acid was insufficient. Five years later, his serum IgG4 level was found to increase. His liver biopsy specimens showed features of nonsuppurative destructive cholangitis in some portal tracts and periductal fibrosis with dense infiltration of IgG4-positive cells in other portal tracts. This case demonstrates that the serum IgG4 level may be worth measuring in patients with PBC refractory to conventional treatment. |
doi_str_mv | 10.2169/internalmedicine.53.2250 |
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A 61-year-old man was diagnosed with PBC due to abnormal liver biochemical tests and positivity for serum anti-M2 antibody. However, his response to bezafibrate and ursodeoxycholic acid was insufficient. Five years later, his serum IgG4 level was found to increase. His liver biopsy specimens showed features of nonsuppurative destructive cholangitis in some portal tracts and periductal fibrosis with dense infiltration of IgG4-positive cells in other portal tracts. This case demonstrates that the serum IgG4 level may be worth measuring in patients with PBC refractory to conventional treatment.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.53.2250</identifier><identifier>PMID: 24990335</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>autoimmune liver disease ; Bezafibrate - therapeutic use ; Cholagogues and Choleretics - therapeutic use ; Cholangitis, Sclerosing - complications ; Cholangitis, Sclerosing - diagnosis ; Drug Therapy, Combination ; Humans ; Immunoglobulin G - blood ; immunoglobulin G4-related sclerosing cholangitis ; Liver Cirrhosis, Biliary - complications ; Liver Cirrhosis, Biliary - diagnosis ; Male ; Middle Aged ; overlap ; primary biliary cirrhosis ; Ursodeoxycholic Acid - therapeutic use</subject><ispartof>Internal Medicine, 2014, Vol.53(13), pp.1429-1433</ispartof><rights>2014 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c584t-cd319e3120ea07d6e99e454ff9ea91a7fff00527602d7ce36d6b0a30c3a2bd0f3</citedby><cites>FETCH-LOGICAL-c584t-cd319e3120ea07d6e99e454ff9ea91a7fff00527602d7ce36d6b0a30c3a2bd0f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,1885,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24990335$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takemoto, Reika</creatorcontrib><creatorcontrib>Miyake, Yasuhiro</creatorcontrib><creatorcontrib>Harada, Kenichi</creatorcontrib><creatorcontrib>Nakanuma, Yasuni</creatorcontrib><creatorcontrib>Moriya, Akio</creatorcontrib><creatorcontrib>Ando, Masaharu</creatorcontrib><creatorcontrib>Hirohata, Mamoru</creatorcontrib><creatorcontrib>Yamamoto, Kazuhide</creatorcontrib><title>Overlap of IgG4-related Sclerosing Cholangitis and Primary Biliary Cirrhosis</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>We herein present a case of an overlap of immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) and primary biliary cirrhosis (PBC). A 61-year-old man was diagnosed with PBC due to abnormal liver biochemical tests and positivity for serum anti-M2 antibody. However, his response to bezafibrate and ursodeoxycholic acid was insufficient. Five years later, his serum IgG4 level was found to increase. His liver biopsy specimens showed features of nonsuppurative destructive cholangitis in some portal tracts and periductal fibrosis with dense infiltration of IgG4-positive cells in other portal tracts. This case demonstrates that the serum IgG4 level may be worth measuring in patients with PBC refractory to conventional treatment.</description><subject>autoimmune liver disease</subject><subject>Bezafibrate - therapeutic use</subject><subject>Cholagogues and Choleretics - therapeutic use</subject><subject>Cholangitis, Sclerosing - complications</subject><subject>Cholangitis, Sclerosing - diagnosis</subject><subject>Drug Therapy, Combination</subject><subject>Humans</subject><subject>Immunoglobulin G - blood</subject><subject>immunoglobulin G4-related sclerosing cholangitis</subject><subject>Liver Cirrhosis, Biliary - complications</subject><subject>Liver Cirrhosis, Biliary - diagnosis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>overlap</subject><subject>primary biliary cirrhosis</subject><subject>Ursodeoxycholic Acid - therapeutic use</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkM9PwjAUgBujEUT_BbOjl2Hbt27rUYkiCQkm6rkp3SuUjA3bYeJ_bxeQg_Hy3uF979dHSMLomLNc3rumQ9_oeouVM67BsYAx54KekSGDTKYFB3FOhlSyMuUxDMhVCBtKoSwkvyQDnklJAcSQzBdf6Gu9S1qbzFbTLPVY6w6r5M3U6NvgmlUyWbe1blaucyHRTZW8erfV_jt5dLXr88R5v45ouCYXVtcBb455RD6en94nL-l8MZ1NHuapEWXWpaYCJhEYp6hpUeUoJWYis1ailkwX1lpKBS9yyqvCIORVvqQaqAHNlxW1MCJ3h7k7337uMXRq64LBOl6J7T4oJjLgJRTxxREpD6iJzwSPVu0O1ytGVe9S_XWpBKjeZWy9PW7ZL2Px1PgrLwKLA7AJnV7hCdC-c9Hev5MZ9PG44kSatfYKG_gB-qKS3A</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Takemoto, Reika</creator><creator>Miyake, Yasuhiro</creator><creator>Harada, Kenichi</creator><creator>Nakanuma, Yasuni</creator><creator>Moriya, Akio</creator><creator>Ando, Masaharu</creator><creator>Hirohata, Mamoru</creator><creator>Yamamoto, Kazuhide</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140101</creationdate><title>Overlap of IgG4-related Sclerosing Cholangitis and Primary Biliary Cirrhosis</title><author>Takemoto, Reika ; Miyake, Yasuhiro ; Harada, Kenichi ; Nakanuma, Yasuni ; Moriya, Akio ; Ando, Masaharu ; Hirohata, Mamoru ; Yamamoto, Kazuhide</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c584t-cd319e3120ea07d6e99e454ff9ea91a7fff00527602d7ce36d6b0a30c3a2bd0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>autoimmune liver disease</topic><topic>Bezafibrate - therapeutic use</topic><topic>Cholagogues and Choleretics - therapeutic use</topic><topic>Cholangitis, Sclerosing - complications</topic><topic>Cholangitis, Sclerosing - diagnosis</topic><topic>Drug Therapy, Combination</topic><topic>Humans</topic><topic>Immunoglobulin G - blood</topic><topic>immunoglobulin G4-related sclerosing cholangitis</topic><topic>Liver Cirrhosis, Biliary - complications</topic><topic>Liver Cirrhosis, Biliary - diagnosis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>overlap</topic><topic>primary biliary cirrhosis</topic><topic>Ursodeoxycholic Acid - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takemoto, Reika</creatorcontrib><creatorcontrib>Miyake, Yasuhiro</creatorcontrib><creatorcontrib>Harada, Kenichi</creatorcontrib><creatorcontrib>Nakanuma, Yasuni</creatorcontrib><creatorcontrib>Moriya, Akio</creatorcontrib><creatorcontrib>Ando, Masaharu</creatorcontrib><creatorcontrib>Hirohata, Mamoru</creatorcontrib><creatorcontrib>Yamamoto, Kazuhide</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takemoto, Reika</au><au>Miyake, Yasuhiro</au><au>Harada, Kenichi</au><au>Nakanuma, Yasuni</au><au>Moriya, Akio</au><au>Ando, Masaharu</au><au>Hirohata, Mamoru</au><au>Yamamoto, Kazuhide</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Overlap of IgG4-related Sclerosing Cholangitis and Primary Biliary Cirrhosis</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>53</volume><issue>13</issue><spage>1429</spage><epage>1433</epage><pages>1429-1433</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>We herein present a case of an overlap of immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) and primary biliary cirrhosis (PBC). A 61-year-old man was diagnosed with PBC due to abnormal liver biochemical tests and positivity for serum anti-M2 antibody. However, his response to bezafibrate and ursodeoxycholic acid was insufficient. Five years later, his serum IgG4 level was found to increase. His liver biopsy specimens showed features of nonsuppurative destructive cholangitis in some portal tracts and periductal fibrosis with dense infiltration of IgG4-positive cells in other portal tracts. This case demonstrates that the serum IgG4 level may be worth measuring in patients with PBC refractory to conventional treatment.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>24990335</pmid><doi>10.2169/internalmedicine.53.2250</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | autoimmune liver disease Bezafibrate - therapeutic use Cholagogues and Choleretics - therapeutic use Cholangitis, Sclerosing - complications Cholangitis, Sclerosing - diagnosis Drug Therapy, Combination Humans Immunoglobulin G - blood immunoglobulin G4-related sclerosing cholangitis Liver Cirrhosis, Biliary - complications Liver Cirrhosis, Biliary - diagnosis Male Middle Aged overlap primary biliary cirrhosis Ursodeoxycholic Acid - therapeutic use |
title | Overlap of IgG4-related Sclerosing Cholangitis and Primary Biliary Cirrhosis |
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