Inflammatory Demyelinating Pseudotumor With Liver Dysfunction: IgG4 Related Disease With Primary Biliary Cholangitis

Am J Med Sci. 2020 Oct;360(4):410-413. doi: 10.1016/j.amjms.2020.05.031. Epub 2020 May 28.

Abstract

Immunoglobulin G4 related disease (IgG4-RD) is a recently recognized immune-mediated disease which is far from understanding. A case of inflammatory demyelinating pseudotumor had been confirmed as IgG4-RD according to pathology features and clinical context. Combined with liver dysfunction, IgG4 related sclerotic cholangitis was suspected. However, primary biliary cholangitis was finally diagnosed by immune marks and histopathological findings. This is the first report in which mass lesions in the brain parenchyma were caused by IgG4-RD while liver dysfunction was due to primary biliary cholangitis. The clinical features of IgG4-RD are miscellaneous, and the accumulation of case reports might enrich clinicians experience and broaden their horizons about this condition.

Keywords: Diagnosis; IgG4 related disease; Inflammatory demyelinating pseudotumor; Primary biliary cholangitis; Therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Demyelinating Autoimmune Diseases, CNS / complications*
  • Demyelinating Autoimmune Diseases, CNS / drug therapy
  • Demyelinating Autoimmune Diseases, CNS / pathology
  • Diagnosis, Differential
  • Granuloma, Plasma Cell / complications*
  • Granuloma, Plasma Cell / drug therapy
  • Granuloma, Plasma Cell / pathology
  • Humans
  • Immunoglobulin G / immunology*
  • Immunoglobulin G4-Related Disease / complications*
  • Immunoglobulin G4-Related Disease / drug therapy
  • Immunoglobulin G4-Related Disease / pathology
  • Liver Cirrhosis, Biliary / complications*
  • Liver Cirrhosis, Biliary / diagnosis
  • Liver Cirrhosis, Biliary / drug therapy
  • Liver Function Tests
  • Magnetic Resonance Imaging
  • Male
  • Treatment Outcome

Substances

  • Immunoglobulin G