■自身免疫性胰腺炎(AIP)患者有时会出现胆囊(GB)壁增厚,名称的条件,IgG4相关性胆囊炎,被提议了。我们检查了IgG4相关疾病患者中GB的放射学发现以及GB壁增厚患者的临床特征,并提出了其发病机理的假设。
■GB壁增厚定义为厚度≥4mm。在258例IgG4相关疾病患者中检查了GB壁厚。然后比较了200例有或没有GB壁增厚的AIP患者的临床和影像学表现。
■在58例(29%)AIP患者和2例孤立的IgG4相关性硬化性胆管炎患者中检测到GB壁增厚。在所检查的60GB中,壁增厚是弥漫性的,墙壁具有光滑的内表面。在56例无AIP或IgG4相关硬化性胆管炎的IgG4相关疾病患者中未检测到GB壁增厚。在56例(97%)的AIP伴GB壁增厚的患者中检测到胆管狭窄。导管内超声检查显示,在14例AIP或IgG4相关性硬化性胆管炎伴GB壁增厚的患者中,有11例(79%)与胆管壁增厚有关。48例诊断为IgG4相关性胆囊炎的患者在接受类固醇治疗后经历了GB壁增厚的消退。
■IgG4相关疾病中的大多数GB壁增厚病例与IgG4相关硬化性胆管炎密切相关,可能是整个胆道IgG4相关疾病的表现,包括胆管,胆囊管,和GB。
UNASSIGNED: Gallbladder (GB) wall thickening sometimes occurs in patients with autoimmune pancreatitis (AIP), a condition for which the name, IgG4-related cholecystitis, was proposed. We examined the radiological findings of the GB in patients with IgG4-related diseases and clinical features of patients with GB wall thickening and presented a hypothesis of its pathogenesis.
UNASSIGNED: GB wall thickening was defined by thickness ≥ 4 mm. GB wall thickness was examined in 258 patients with IgG4-related disease. Clinical and imaging findings of 200 patients with AIP with and without GB wall thickening were then compared.
UNASSIGNED: GB wall thickening was detected in 58 patients (29%) with AIP and two patients with isolated IgG4-related sclerosing cholangitis. In the 60 GBs examined, wall thickening was diffuse, with the walls possessing a smooth inner surface. No GB wall thickening was detected among the 56 patients with IgG4-related disease without AIP or IgG4-related sclerosing cholangitis. Bile duct stenosis was detected in 56 patients (97%) with AIP with GB wall thickening. Intraductal ultrasonography indicated cystic duct wall thickening connected to bile duct wall thickening in 11 of 14 (79%) patients with AIP or IgG4-related sclerosing cholangitis with GB wall thickening. Forty-eight patients in whom IgG4-related cholecystitis was diagnosed experienced resolution of the GB wall thickening after receiving steroid therapy.
UNASSIGNED: Most cases of GB wall thickening in IgG4-related diseases are closely associated with IgG4-related sclerosing cholangitis and may be a manifestation of IgG4-related disease throughout the biliary tract, including the bile duct, cystic duct, and GB.