摘要
Abstract
Objective To investigate the diagnosis and treatment measures,causes of misdiagnosis and preventive measures of IgG4-related digestive system diseases.Methods Clinical data of 9 patients with IgG4-related digestive system diseases misdiagnosed as gastrointestinal tumors such as pancreatic cancer or cholangiocarcinoma from January 2021 to June 2023 were retrospectively analyzed.Results Four patients were admitted with jaundice,four with abdominal pain,and one with abdominal pain,diarrhea and fever as the main manifestations.Of these,8 had elevated IgG4 and 1 had normal IgG4.There was an increase in carcinoembryonic antigen(CEA)and cancer antigen 125(CA125)in 3 patients,CA199 in 2 pa-tients,antinuclear antibody(ANA)in 2 patients,and rheumatoid factor(RF)in 2 patients.Two patients had abnormal thy-roid function and three patients had abnormal liver function.Hyperglycemia occurred in 2 patients,and amylase and lipase in-creased in 3 patients.Five patients were misdiagnosed with pancreatic cancer,three with cholangiocarcinoma,and one with intestinal lymphoma.The duration of misdiagnosis ranged from 2 months to 1.5 years.All patients underwent biopsy,and IgG4-related digestive system diseases were considered in combination with CT and MR.After diagnosis,patients were treated with glucocorticoid,symptoms were ameliorated,and tumor markers and IgG4 were normal.After the amelioration of symp-toms,2 patients stopped the medication on their own;the symptoms of abdominal pain reappeared,and IgG4 was elevated again.Glucocorticoid was resumed,which was effective in these two patients.Currently,all patients were followed up and no evidence of digestive tract tumor was found.Conclusion IgG4-related digestive system diseases are lack of specific clinical manifestations and examination methods,making it more likely to be misdiagnosed as digestive tract tumors.Clinicians should improve their understanding of this disease,perform relevant examinations in time,and make a comprehensive analysis based on medical history,imaging,pathology and other results.Confirmed patients should be given glucocorticoids as early as possi-ble.关键词
IgG4 相关性疾病/误诊/胰腺肿瘤/胆管肿瘤/肠道淋巴瘤/癌胚抗原/抗体,抗核/类风湿因子Key words
Immunoglobulin G4-related disease/Misdiagnosis/Pancreatic neoplasms/Bile duct neoplasms/Intesti-nal lymphoma/Carcinoembryonic antigen/Antibodies,antinuclear/Rheumatoid factor分类
医药卫生
