IgG4-Negative Autoimmune Pancreatitis with Sclerosing Cholangitis and Colitis: Possible Association with Primary Sclerosing Cholangitis?
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概要
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We report a case of autoimmune pancreatitis (AIP) with cholangiography and histopathology showing features characteristic of primary sclerosing cholangitis (PSC) and colitis. A 55-year-old previously-healthy man was diagnosed with anti-nuclear antibody (ANA)-positive AIP according to the finding of serum biochemistry, abdominal US (ultrasonography), CT (computed tomography) and ERCP (endoscopic retrograde cholangiopancreatography). However, bead-like strictures of intrahepatic bile ducts were also found and liver tissue showed onion skin-like periductal fibrosis but no anti-IgG4-positive cells. In addition, colon fiberscopy showed a pancolitis similar to ulcerative colitis indicating that, in this case, there may be an association with PSC. Here, we report a rare case of IgG4-negative AIP with sclerosing cholangitis and colitis with many clinical features that support an association with PSC.
著者
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Hibi Toshifumi
Division Of Gastroenterology And Hepatology Department Of Internal Medicine Keio University School O
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Kameyama Kaori
Department Of Pathology Keio University School Of Medicine
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IWAO Yasushi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine
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Soma Hiromitsu
Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine
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Saeki Keita
Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine
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Hozawa Shigenari
Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine
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Miyata Naoteru
Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine
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Nishizawa Toshihiro
Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine
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Iwao Yasushi
Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine
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