Differentiating Immunoglobulin G4-Related Sclerosing Cholangitis from Hilar Cholangiocarcinoma
Gut and Liver
;
: 234-238, 2013.
Article
in English
| WPRIM
| ID: wpr-177978
ABSTRACT
BACKGROUND/AIMS:
Few studies have differentiated immunoglobulin G (IgG) 4-related sclerosing cholangitis (IgG4-SC) from hilar cholangiocarcinoma (CC). Thus, we sought to investigate useful features for differentiating IgG4-SC from hilar CC.METHODS:
We retrospectively compared clinical, serological, imaging, and histological features of six patients with IgG4-SC and 42 patients with hilar CC.RESULTS:
In patients with hilar CC, obstructive jaundice was more frequent (p<0.01), serum total bilirubin levels were significantly higher (p<0.05), serum CA19-9 levels were significantly higher (p<0.01), and serum duke pancreatic monoclonal antigen type 2 levels were frequently elevated (p<0.05). However, in patients with IgG4-SC, the serum IgG (p<0.05) and IgG4 (p<0.01) levels were significantly higher and frequently elevated. The pancreas was enlarged in all IgG4-SC patients but only in 17% of hilar CC patients (p<0.01). Salivary and/or lacrimal gland swelling was detected in only 50% of IgG4-SC patients (p<0.01). Endoscopic retrograde cholangiography revealed that the hilar or hepatic duct was completely obstructed in 83% of hilar CC patients (p<0.01). Lower bile duct stenosis, apart from hilar bile duct stenosis, was more frequent in IgG4-SC patients (p<0.01). Bile duct wall thickening in areas without stenosis was more frequent in IgG4-SC patients (p<0.01).CONCLUSIONS:
An integrated diagnostic approach based on clinical, serological, imaging, and histological findings is necessary to differentiate IgG4-SC from hilar CC.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pancreas
/
Bile Ducts
/
Bilirubin
/
Immunoglobulin G
/
Immunoglobulins
/
Cholangiography
/
Cholangitis, Sclerosing
/
Retrospective Studies
/
Cholangiopancreatography, Endoscopic Retrograde
/
Cholangiocarcinoma
Type of study:
Observational study
Limits:
Humans
Language:
English
Journal:
Gut and Liver
Year:
2013
Type:
Article
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