IgG4-related Sclerosing Cholangitis with No Biliary Stricture but Severe Thickening of the Bile Duct Wall

Shuya Shimizu; Itaru Naitoh; Takahiro Nakazawa; Kazuki Hayashi; Katsuyuki Miyabe; Hiromu Kondo; Yuji Nishi; Michihiro Yoshida; Shuichiro Umemura; Yasuki Hori; Akihisa Kato; Hirotaka Ohara; Toshiya Kuno; Satoru Takahashi; Takashi Joh

doi:10.2169/internalmedicine.55.6302

CASE REPORTS

IgG4-related Sclerosing Cholangitis with No Biliary Stricture but Severe Thickening of the Bile Duct Wall

Shuya Shimizu, Itaru Naitoh, Takahiro Nakazawa, Kazuki Hayashi, Katsuyuki Miyabe, Hiromu Kondo, Yuji Nishi, Michihiro Yoshida, Shuichiro Umemura, Yasuki Hori, Akihisa Kato, Hirotaka Ohara, Toshiya Kuno, Satoru Takahashi, Takashi Joh

Author information

Shuya Shimizu
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Itaru Naitoh
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Takahiro Nakazawa
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Kazuki Hayashi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Katsuyuki Miyabe
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Hiromu Kondo
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Yuji Nishi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Michihiro Yoshida
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Shuichiro Umemura
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Yasuki Hori
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Akihisa Kato
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Hirotaka Ohara
Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Japan
Toshiya Kuno
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Japan
Satoru Takahashi
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Japan
Takashi Joh
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan

Keywords: autoimmune pancreatitis, IgG4-related sclerosing cholangitis, endoscopic cholangiography, cholangiographic classification

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 12 Pages 1575-1579

DOI https://doi.org/10.2169/internalmedicine.55.6302

Details

Abstract

We herein report a case of a 56-year-old man with IgG4-related sclerosing cholangitis (IgG4-SC) with no biliary stricture, but with a severely thickened bile duct wall. Contrast-enhanced computed tomography showed diffuse swelling of the pancreas and thickening of the common bile duct (CBD) wall with delayed enhancement. Obvious diffuse wall thickening of the CBD was observed on endoscopic ultrasonography. However, endoscopic retrograde cholangiography showed no biliary stricture in the CBD that had thickened. Although IgG4-SC has been classified by a stenotic lesion on cholangiography, we should be aware of some IgG4-SC cases showing only bile duct wall thickness without any biliary stricture.

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