Autoimmune Hemolytic Anemia Obscured by the Obstructive Jaundice Associated with IgG4-related Sclerosing Cholangitis in a Patient with Type 1 Autoimmune Pancreatitis: A Case Report and Review of the Literature

Michihiro Yoshida; Yoshiaki Marumo; Itaru Naitoh; Kazuki Hayashi; Katsuyuki Miyabe; Yuji Nishi; Yasuaki Fujita; Naruomi Jinno; Yasuki Hori; Makoto Natsume; Akihisa Kato; Shinsuke Iida; Takashi Joh

doi:10.2169/internalmedicine.9818-17

This article has now been updated. Please use the final version.

Autoimmune Hemolytic Anemia Obscured by the Obstructive Jaundice Associated with IgG4-related Sclerosing Cholangitis in a Patient with Type 1 Autoimmune Pancreatitis: A Case Report and Review of the Literature

Michihiro Yoshida, Yoshiaki Marumo, Itaru Naitoh, Kazuki Hayashi, Katsuyuki Miyabe, Yuji Nishi, Yasuaki Fujita, Naruomi Jinno, Yasuki Hori, Makoto Natsume, Akihisa Kato, Shinsuke Iida, Takashi Joh

Author information

Michihiro Yoshida
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Yoshiaki Marumo
Department of Hematology and Oncology, 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
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
Yuji Nishi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Yasuaki Fujita
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan
Naruomi Jinno
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
Makoto Natsume
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
Shinsuke Iida
Department of Hematology and Oncology, 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 (AIP), Autoimmune hemolytic anemia (AIHA), IgG4-related disease (IgG4-RD), IgG4-related sclerosing cholangitis (IgG4-SC)

JOURNAL OPEN ACCESS Advance online publication

Article ID: 9818-17

DOI https://doi.org/10.2169/internalmedicine.9818-17

The final version of this article is now available: Vol. 57 (2018), No. 12 pp. 1725-1732

Details

Abstract

Type 1 autoimmune pancreatitis (AIP) is a pancreatic manifestation of IgG4-retated disease that is often associated with IgG4-related sclerosing cholangitis (IgG4-SC). Autoimmune hemolytic anemia (AIHA) is an immune-related disease that causes hemolytic anemia. Although type 1 AIP/IgG4-SC and AIHA have a shared etiology as a presumed autoimmune disease, they rarely overlap, and their association has not been clarified. Secondary AIHA might not be diagnosed appropriately because the obstructive jaundice observed in type 1 AIP/IgG4-SC can obscure the presence of hemolytic jaundice. We herein report a case of type 1 AIP/IgG4-SC overlapping with secondary AIHA along with a review of the literature.

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