Nisan 2017
Primer sklerozan kolanjiti taklit eden otoimmün kolanjiyopati: Vaka sunumu
Autoimmune cholangiopathy mimicking primary sclerosan cholangitis: A case report
- Ana Sayfa
- Sayılar
- Nisan 2017
- Primer sklerozan kolanjiti taklit eden otoimmün kolanjiyopati: Vaka sunumu ...
Muhammet Yener AKPINAR, Bülent ÖDEMIS, Sabite KAÇAR, Hale GÖKCAN, Ufuk Baris KUZU,Ertugrul KAYAÇETIN
Özet
Otoimmün kolanjiyopati veya immünglobulin G4 iliskili sklerozan kolanjit immün sistem iliskili bir kolanjit tipidir. Otoimmün pankreatit sikliklabu duruma eslik eder; bununla beraber hastalarin çok az bir yüzdesindeotoimmün kolanjiyopati tek basina da görülebilir. 69 yasinda kadin hasta klinigimize halsizlik, kasinti ve sarilikla basvurdu. Endoskopik retrograd kolanjiopankreatografi de intrahepatik safra yollarinda çok sayidadarlik ve dilatasyonlarla beraber ana koledok distalde darliga rastlandi.Sklerozan kolanjitin diger nedenlerini ekarte edebilmek için hastadanimmünglobulin G4 çalisildi ve sonuç 1.200 mg/dl olarak geldi. Bu sonuçla otoimmün kolanjiyopati tanisi kondu. Otoimmün kolanjiyopatiintrahepatik ve/veya extrahepatik safra yollarinda darlik olan hastalarda ayirici tanida mutlaka akilda tutulmalidir. Süphe edilen hastalardaimmünglobulin G4 tarama amaçli kullanilabilir. Otoimmün kolanjiyopatinin tani ve tedavisi hastalari ilerleyen zamanda siroz veya gereksizcerrahiden koruyacaktir.
Abstract
Autoimmune cholangiopathy or IgG4-related sclerosan cholangitis isan immune- mediated type of cholangitis. Autoimmune pancreatitis isfrequently associated with this condition. However, in a minority ofpatients, autoimmune cholangiopathy exist alone. A 69- year-old female patient was admitted to our hospital with fatigue, pruritus, andjaundice. There were multiple strictures and dilations in the intrahepaticbiliary tree with stricture in the distal part of the common bile duct. Toexclude other causes of sclerosan cholangitis, IgG4 was studied. TheIgG4 titer was 1200 mg/dl; therefore, the diagnosis was autoimmunecholangiopathy. Autoimmune cholangiopathy must be investigated inpatients with biliary strictures in either the intrahepatic or extrahepaticbile ducts. IgG4 can be used to screen for autoimmune cholangitis. Diagnosis and treatment of this condition prevents patients from cirrhosisand unnecessary surgery.
