Sequential Evaluation of Pancreato-Biliary Findings in a Case with IgG4-Associated Cholangiopathy and Autoimmune Pancreatitis during Corticosteroid Treatment

Abstract

Background: Immunoglobulin G4 (IgG4)-associated dis-eases mostly involve the pancreatico-biliary tree and pan-creatic parenchyma. This disease complex is characterized by marked response to corticosteroid therapy and response to steroids is incorporated in the diagnostic algorithm of IgG4 associated diseases. However, there is much unknown about the sequences and duration of healing during the cor-ticosteroid therapy in the literature.Case Report: In this case report, we report a young male patient with IgG4 associated extrahepatic biliary stricture and autoimmune pancreatitis successfully treated with corticosteroids. Recovery in the laboratory and radiologi-cal findings seemed to correlate well with the decrease in serum IgG4 levels in this patient. We also discussed se-quences and the duration of healing in the pancreaticobili-ary tree and pancreatic parenchymal manifestations in this case report.Conclusion: There is a gap in our knowledge about the evaluation of response criteria after steroid trial with regard to the duration and sequences of healing in the pancreatico-biliary involvement in diagnosing IgG4-related biliary and pancreatic diseases