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Colegio de Medicina Interna de México.

2024, Number 5

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Med Int Mex 2024; 40 (5)

IgG4-related cholangitis

García FW, Villafuerte TI, Mexia AAL, Prado HD

Language: Spanish
References: 47
Page: 295-304
PDF size: 397.15 Kb.


ABSTRACT

Background: Cholangitis is a fibroinflammatory disease, almost always due to obstructive jaundice, which is difficult to differentiate from primary sclerosing cholangitis by imaging; its diagnosis is based on elevated serum IgG4 concentrations and histopathological data.
Objective: To describe the concept and current classification of SC-IgG4 according to different associations, as well as the pathogenic, epidemiological, clinical and therapeutic aspects.
Methodology: Bibliographic search in the databases GoogleScholar, PubMed, Medline LILACS and Scopus, articles in English and Spanish were included.
Results: From the bibliographic review, 60 articles were obtained that met the inclusion criteria, of which 13 were discarded due to several reasons (letters to the editor, case reports and duplicate reviews). To date there are no unified criteria in relation to the diagnosis, classification and management of SC-IgG4. Similarities and differences in relation to the diagnostic criteria of SC-IgG4 between the Endoscopy Society of Japan and the Gastroenterology Societies of Europe and the United States were found. A significant proportion of SC-IgG4 cases present high levels of IgG4 in the blood and usually respond satisfactorily to corticosteroids.
Conclusions: IgG4-related sclerosing cholangitis is a biliary manifestation of the disease related to IgG4, it is very difficult to diagnose and is often confused with cholangiocarcinoma and other types of cholangitis. IgG4-related sclerosing cholangitis has a very good prognosis and responds satisfactorily to corticosteroids.


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