A case of duodenal ulcer as prominent manifestation of IgG4-related disease

• Published in: Beijing da xue xue bao. Journal of Peking University. Yi xue ban Vol. 55; no. 6; pp. 1125 - 1129
• Main Authors: Feng, Min, Chen, Zhe, Cheng, Yong Jing
• Format: Journal Article
• Language: Chinese
• Published: China 18-12-2023
• Subjects: Abdominal Pain - drug therapy; Acute Disease; Aged; Bilirubin; Duodenal Ulcer - diagnosis; Duodenal Ulcer - drug therapy; Duodenal Ulcer - etiology; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease - complications; Immunoglobulin G4-Related Disease - diagnosis; Male; Pancreatitis - drug therapy; Positron Emission Tomography Computed Tomography; Prednisone - therapeutic use; Pruritus - drug therapy; Digestive tract hemorrhage; Duodenal ulcer; IgG4-related disease
• ISSN: 1671-167X
• DOI: 10.19723/j.issn.1671-167X.2023.06.026

A case of IgG4-related disease presented with a duodenal ulcer to improve the understan-ding of IgG4-related diseases was reported. A 70-year-old male presented with cutaneous pruritus and abdominal pain for four years and blackened stools for two months. Four years ago, the patient went to hospital for cutaneous pruritus and abdominal pain. Serum IgG4 was 3.09 g/L (reference value 0-1.35 g/L), alanine aminotransferase 554 U/L (reference value 9-40 U/L), aspartate aminotransferase 288 U/L (reference value 5-40 U/L), total bilirubin 54.16 μmol/L (reference value 2-21 μmol/L), and direct bilirubin 29.64 μmol/L (reference value 1.7-8.1 μmol/L) were all elevated. The abdominal CT scan and magnetic resonance cholangiopancreatography indicated pancreatic swelling, common bile duct stenosis, and secondary obstructive dilation of the biliary system. The patient was diagnosed with IgG4-related disease and treated with prednisone at 40 mg daily. As jaundice and abdominal pain improved, prednisone was gradually reduced