PDF(Pubmed)
Abstract：
A man in his 70s presented to the emergency department with painless obstructive jaundice. Initial blood test results show a predominantly cholestatic picture with elevated tumour markers, and imaging findings are concerning for a pancreatic head neoplasm or cholangiocarcinoma with involvement of the entire common bile duct. The patient underwent staging laparoscopy and biopsies including peritoneal washing, but did not identify any features of malignancy. Immunoglobulin G and immunoglobulin G4 testing were subsequently tested and shown to be elevated. The provisional diagnosis of immunoglobulin G4-related sclerosing cholangitis was made, and steroid treatment was empirically started. Treatment with steroids was successful, with complete resolution of symptoms and abnormal imaging findings and near complete resolution of liver function test results after 1 month.
摘要：
一名70多岁的男子因无痛性阻塞性黄疸出现在急诊科。最初的血液检查结果显示主要是胆汁淤积，肿瘤标志物升高，和影像学发现有关胰头肿瘤或胆管癌累及整个胆总管。患者接受了分期腹腔镜检查和活检，包括腹膜冲洗，但没有发现任何恶性肿瘤的特征。随后测试免疫球蛋白G和免疫球蛋白G4测试,并显示升高。初步诊断为免疫球蛋白G4相关性硬化性胆管炎,和类固醇治疗是凭经验开始的。用类固醇治疗是成功的，1个月后，症状完全缓解，影像学检查异常，肝功能检查结果接近完全缓解。
