Immunoglobulin G4-Related Gastric Ulcer Mimicking Advanced Stomach Cancer in a Patient with Type I Autoimmune Pancreatitis
10.3904/kjm.2019.94.3.287
- Author:
Joung Ha PARK
1
;
Jin Hee NOH
;
Jang Ho LEE
;
Goeun LEE
;
Seung Mo HONG
;
Kwang Bum CHO
;
Myung Hwan KIM
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mhkim@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Gastric ulcer;
Pancreatitis;
IgG4-related disease
- MeSH:
Bile Ducts;
Diagnosis;
Gastrectomy;
Humans;
Immunoglobulins;
Kidney;
Middle Aged;
Pancreas;
Pancreatitis;
Pancreatitis, Chronic;
Salivary Glands;
Stomach Neoplasms;
Stomach Ulcer;
Stomach;
Ulcer;
Unnecessary Procedures
- From:Korean Journal of Medicine
2019;94(3):287-293
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Type I autoimmune pancreatitis (AIP), a form of chronic pancreatitis, is included within the spectrum of immunoglobulin G4-related diseases (IgG4-RD). IgG4-RD can involve the salivary glands, bile ducts, kidneys and retroperitoneum, and the pancreas, and responds well to corticosteroid treatment. However, gastric involvement in IgG4-RD has been rarely reported. Here we report the case of a 56-year-old man with type I autoimmune pancreatitis who presented with a giant gastric ulcer mimicking advanced gastric cancer, which was subsequently determined to be IgG4-RD. Both the patient' symptoms and his ulcerative lesions in the stomach responded to steroid treatment, which obviated the need for major surgery such as gastrectomy. Our case demonstrates the importance of recognizing potential gastric involvement in IgG4-RD, especially in a patient with concurrent AIP/IgG4-RD or a history of the disease, who is evaluated for an intractable and/or atypical gastric ulcer. A prompt diagnosis and proper management will avoid unnecessary surgery.
