Semiquantitative measurement of pulmonary hilar gallium-67 uptake using single photon emission computed tomography/computed tomography for the diagnosis of autoimmune pancreatitis.
Purpose
We ascertained the difference in the level of pulmonary hilar (PH) gallium-67 (Ga-67) uptake in autoimmune pancreatitis (AIP) patients between the active (before corticosteroid therapy) and remittent (after 4 weeks of corticosteroid therapy) phases using a semiquantitative measurement method based on single photon emission computed tomography (SPECT) with integrated low-dose computed tomography (CT).
Background/Aims: Autoimmune pancreatitis (AIP) is an IgG4-related systemic disease often accompanied with a variety of lesions outside of the pancreas and is treated with steroid th
Introduction and Aims Autoimmune pancreatitis is characterized by severe lymphocytic inflammation, suggesting that gallium-67 scintigraphy provides a useful tool for detecting characteristic lesions of this disease, because gallium-67 concentrates in lymphoid cells. We tried to determine whether gallium-67 accumulates in the characteristic lesions. Methodology We performed gallium-67 scintigraphy in 24 patients with autoimmune pancreatitis before and after 4 weeks of corticosteroid therapy and d...
Abstract Background & Aims: Autoimmune pancreatitis is a distinctive disease entity characterized by high serum immunoglobulin G4 concentrations. Because of the close association between some autoimmune diseases and particular alleles of major histocompatibility complex genes, we investigated the association between HLA alleles and autoimmune pancreatitis. Methods: HLA-A, -B, -C, -DR, and -DQ gene typing and HLA-DRB1, -DQB1, and -DPB1 allele typing were performed by the polymerase chain reaction...
Summary Sclerosing pancreatitis is associated with raised concentrations of lgG4. We treated 22 patients with sclerosing pancreatitis, and identified and followed-up three with concomitant hydronephrosis caused by ureteral mass, later diagnosed as retroperitoneal fibrosis. We histologically examined the ureteral and pancreatic lesions of these patients and noted abundant infiltration of lgG4-bearing plasma cells in both tissues. Treatment with corticosteroids lowered serum concentrations of lgG4...
Abstract Background: Autoimmune pancreatitis has been proposed as a new clinical entity. However, the ERCP features of this entity have not been well described. Methods: Clinical and radiographic features in 27 patients with a diagnosis of autoimmune pancreatitis were evaluated. Results: All 27 patients were at first suspected to have pancreatic cancer. The patients were predominantly elderly men and presented with jaundice or mild symptoms and pancreatic enlargement, but no attack of acute panc...
Background Sclerosing pancreatitis is a unique form of pancreatitis that is characterized by irregular narrowing of the main pancreatic duct, lymphoplasmacytic inflammation of the pancreas, and hypergammaglobulinemia and that responds to glucocorticoid treatment. Preliminary studies suggested that serum IgG4 concentrations are elevated in this disease but not in other diseases of the pancreas or biliary tract. Methods We measured serum IgG4 concentrations using single radial immunodiffusion and ...
Abstract Background & Aims: Although autoimmunity may be involved in some cases of pancreatitis, the mechanism is still unknown. To clarify this, we studied serum autoantibodies, subsets of lymphocytes, and the Th1/Th2 balance of cellular immune responses in patients with autoimmune-related pancreatitis (AIP). Methods: Seventeen patients with AIP (8 men and 9 women; age, 53.2 ± 13.0 years) were studied. Autoantibodies including antilactoferrin (ALF) or carbonic anhydrase II antibody (ACA-II) wer...
Summary Four patients with weight loss, jaundice, a sonolucent swelling of the pancreas, and multiple bile-duct strictures are described. These cases of sclerosing pancreato-cholangitis responded to steroid therapy.
Scintigraphy with single-photon radionuclides is a useful means of detecting various functional abnormalities in organs affected by IgG4-related disease (IgG4-RD). Notable examples include 67Ga to depict the inflammatory activity associated with IgG4-RD, salivary gland scintigraphy to delineate the degree of salivary gland injury, and renal scintigraphy to quantify changes in blood flow and functional impairment in the presence of renal lesions. In particular, 67Ga scintigraphy is a modality tha...
IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma c...