Immunoglobulin G4-related Liver Disease Overlapping with Non-alcoholic Steatohepatitis That Was Diagnosed Simultaneously with Autoimmune Pancreatitis: A Case Report and Review of the Literature.

Abstract

A 70-year-old woman was referred to our hospital due to symptoms of dry eyes, dry mouth, and epigastric pain. Computed tomography showed distal pancreatic swelling, liver edge dullness and surface irregularities. Serum anti-nuclear antibody titers, immunoglobulin G and IgG4 levels were elevated. Autoimmune pancreatitis (AIP) was diagnosed based on endoscopic findings and a histopathological examination. Her AIP improved after starting prednisolone treatment. A liver biopsy revealed interface hepatitis with lymphoplasmacyte and IgG4-positive plasma cell infiltration. In addition, non-alcoholic steatohepatitis (NASH) was diagnosed based on the presence of parenchymal steatosis, ballooning hepatocytes, and pericellular fibrosis. We experienced a unique liver disease case showing IgG4-related liver disease overlapping with NASH.

• Authors: Kotaro Matsumoto, Kentaro Kikuchi, Noriyuki Kuniyoshi, Hiromichi Tsunashima, Katsunori Sekine, Masatoshi Mabuchi, Shinpei Doi, Yoh Zen, Hiroshi Miyakawa
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 58 Issue 24 Pg. 3537-3543 (Dec 15 2019) ISSN: 1349-7235 [Electronic] Japan
• PMID: 31366800 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antibodies, Antinuclear
• Immunoglobulin G
• Prednisolone

Topics

• Adult
• Aged
• Antibodies, Antinuclear (blood)
• Autoimmune Pancreatitis (complications, diagnosis)
• Biopsy
• Blood Chemical Analysis
• Female
• Hepatitis (complications, pathology)
• Humans
• Immunoglobulin G (blood)
• Liver (diagnostic imaging, pathology)
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease (complications, pathology)
• Pancreas (pathology)
• Prednisolone (therapeutic use)
• Tomography, X-Ray Computed