在IgG4相关的自身免疫性胰腺炎中显著的CA 19-9升高 - 一个诊断困境
Larabe Farrukh1, Muhammad Farhan Akhtar1, Hafiza Hareem Waqar1
1Department of Medicine, Albany Medical Center, Albany, NY, USA.
The American journal of the medical sciences
|September 15, 2023
概括
免疫球蛋白G4相关疾病 (IgG4-RD) 可以模仿癌症. 这一案例凸显了IgG4-RD自身免疫性胰腺炎和硬化性胆道炎如何表现出癌症标志物升高,但对治疗反应良好.
科学领域:
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 免疫球蛋白G4相关疾病 (IgG4-RD) 是一种纤维炎症性疾病.
- CA19-9水平升高可能表明恶性瘤,但也可能表明IgG4-RD自身免疫性胰腺炎 (AIP) 和硬化性胆道炎 (IgG4-SC).
- 区分IgG4-RD和胰腺胆道恶性瘤可能是一个挑战.
研究的目的:
- 为了呈现一种IgG4-RD自身免疫性胰腺炎和硬化性胆道炎的病例.
- 为了说明IgG4-RD中CA19-9水平升高所带来的诊断挑战.
- 为了证明IgG4-RD治疗的有效性.
主要方法:
- 一个65岁的男性病例报告,有IgG4-RD病史.
- 黄和腹痛的临床表现与胰腺质量.
- 诊断程序包括ERCP和活检,以及IgG4和CA19-9水平测量.
主要成果:
- 这位患者出现了胰腺质量,IgG4 (162 mg/dL) 和CA19-9 (2830 U/mL) 水平升高.
- ERCP和活检排除了胰腺癌和胆管癌.
- 诊断为IgG4-RD自身免疫性胰腺炎和硬化性胆道炎.
结论:
- IgG4-RD可以呈现显著升高的CA19-9水平,模仿恶性瘤.
- 用类固醇和修复剂治疗导致临床改善,并降低CA19-9水平.
- 这一案例强调了在高瘤标志物胰腺质量差异诊断中考虑IgG4-RD的重要性.
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