| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000418470 |
| ISSN: | 1665-2681 |
| Authors: | Clendenon, Jacob N1 Aranda Michel, Jaime1 Krishna, Murli2 Taner, C. Burcin1 Willingham, Darrin L1 |
| Institutions: | 1Mayo Clinic Florida, Department of Transplantation, Jacksonville, Florida. Estados Unidos de América 2Mayo Clinic Florida, Department of Laboratory Medicine and Pathology, Jacksonville, Florida. Estados Unidos de América |
| Year: | 2011 |
| Season: | Oct-Dic |
| Volumen: | 10 |
| Number: | 4 |
| Pages: | 562-564 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Caso clínico |
| English abstract | Immunoglobulin G4 associated cholangitis (IAC) is an autoimmune disease associated with autoimmune pancreatitis (AIP). It presents with clinical and radiographic findings similar to primary sclerosing cholangitis (PSC). IAC commonly has a faster, more progressive onset of symptoms and it is more common to see obstructive jaundice in IAC patients compared to those with PSC. One of the hallmarks of IAC is its responsiveness to steroid therapy. Current recommendations for treatment of AIP demonstrate excellent remission of the disease and associated symptoms with initiation of steroid therapy followed by steroid tapering. If untreated, it can progress to irreversible liver failure. This report describes a 59 year-old female with undiagnosed IAC who previously had undergone a pancreaticoduodenectomy for a suspected pancreatic cancer and later developed liver failure from presumed PSC. The patient underwent an uncomplicated liver transplantation at our institution, but experienced allograft failure within five years due to progressive and irreversible bile duct injury. Radiology and histology suggested recurrence of PSC, but the diagnosis of IAC was suspected based on her past history and confirmed when IgG4 positive cells were found within the intrahepatic bile duct walls on a liver biopsy. A successful liver retransplantation was performed and the patient is currently on triple immunosuppressive therapy. Our experience in this case and review of the current literature regarding IAC management suggest that patients with suspected or recurrent PSC with atypical features including history of pancreatitis should undergo testing for IAC as this entity is highly responsive to steroid therapy |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Inmunología, Enfermedades autoinmunes, Colangitis, IgG4, Falla hepática |
| Keyword: | Gastroenterology, Immunology, Autoimmune diseases, Cholangitis, IgG4, Liver failure |
| Full text: | Texto completo (Ver PDF) |
