Abstract
We describe a 42-year-old man who presented with painless obstructive jaundice, organomegaly and lymphadenopathy. Biopsy of the ampulla of Vater revealed the presence of increased populations of plasma cells which stained positively for immunoglobulin G4. He was treated with prednisolone and demonstrated significant clinical improvement 1 month later. A further case is described and a review of the literature is also provided.
© 2013 The Authors International Journal of Rheumatic Diseases © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
MeSH terms
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Adult
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Ampulla of Vater / metabolism
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Ampulla of Vater / pathology
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Autoimmune Diseases / diagnosis*
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Autoimmune Diseases / drug therapy
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Autoimmune Diseases / immunology
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Common Bile Duct Diseases / drug therapy
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Common Bile Duct Diseases / immunology
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Common Bile Duct Diseases / pathology*
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Diagnosis, Differential
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Glucocorticoids / therapeutic use
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Humans
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Hypergammaglobulinemia / diagnosis*
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Hypergammaglobulinemia / drug therapy
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Hypergammaglobulinemia / immunology
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Immunoglobulin G / blood*
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Jaundice, Obstructive / diagnosis
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Jaundice, Obstructive / drug therapy
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Jaundice, Obstructive / immunology
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Lymphatic Diseases / diagnosis
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Lymphatic Diseases / drug therapy
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Lymphatic Diseases / immunology
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Lymphoproliferative Disorders / diagnosis*
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Lymphoproliferative Disorders / drug therapy
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Lymphoproliferative Disorders / immunology
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Male
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Plasma Cells / metabolism
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Plasma Cells / pathology
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Prednisolone / therapeutic use
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Sclerosis / diagnosis*
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Sclerosis / drug therapy
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Sclerosis / immunology
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Treatment Outcome
Substances
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Glucocorticoids
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Immunoglobulin G
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Prednisolone