IgG4相关性疾病合并胰腺多发囊肿一例并文献复习

IgG4-Related Disease with Multiple Pancreatic Cysts: a Case Report and Literature Review

  • 摘要: 免疫球蛋白G4相关性疾病(immunoglobulin G4-related disease, IgG4-RD)是一种罕见的系统性免疫介导性疾病,以IgG4阳性浆细胞浸润和多器官纤维化为特征。其中,以胰腺多发囊性病变为突出表现者较为罕见,临床易被误诊为胰腺肿瘤或胰腺炎。本文报道北京协和医院收治的1例IgG4-RD患者,该患者以胰腺多发囊性病变及腹主动脉瘤样扩张为首发症状,血清IgG4水平显著升高,结合颌下腺病理活检,最终确诊为IgG4-RD。予糖皮质激素联合环磷酰胺方案治疗后,患者病情好转。同时,本文对IgG4-RD相关胰腺囊性病变病例进行文献复习,旨在提升临床医师对该少见疾病表型的认识。

     

    Abstract: Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic immune-mediated disorder characterized by infiltration of IgG4-positive plasma cells and multiorgan fibrosis. Among them, cases with multiple pancreatic cystic lesions as the prominent manifestation are relatively rare, and they are easily misdiagnosed as pancreatic tumors or pancreatitis in clinical practice. Herein, we report one patient with IgG4-RD admitted to Peking Union Medical College Hospital. The patient initially presented with multiple pancreatic cystic lesions and aneurysmal dilatation of the abdominal aorta, accompanied by markedly elevated serum IgG4 levels. Combined with pathological findings from submandibular gland biopsy, the diagnosis of IgG4-RD was ultimately established. After treatment with a regimen of glucocorticoids combined with cyclophosphamide, the patient′s condition improved. Meanwhile, we performed a literature review of cases with IgG4-RD-related pancreatic cystic lesions, aiming to improve clinicians′ understanding of this rare disease phenotype.

     

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