- AIM: To investigate presence and extent of eosinophilic cholangitis (EC) as well as IgG4-related disease in patients with indeterminate biliary stricture (IBS).
METHODS: All patients with diagnosis of sclerosing cholangitis (SC) and histopathological samples such as biopsies or surgical specimens at University Hospital Frankfurt from 2005-2015 were included. Histopathological diagnoses as well as further clinical course were reviewed. Tissue samples of patients without definite diagnosis after complete diagnostic work-up were reviewed regarding presence of eosinophilic infiltration and IgG4 positive plasma cells. Eosinophilic infiltration was as well assessed in a control group of liver transplant donors and patients with primary sclerosing cholangitis.
RESULTS: one hundred and thirty-five patients with SC were included. In 10/135 (13.5%) patients, no potential cause of IBS could be identified after complete diagnostic work-up and further clinical course. After histopathological review, a post-hoc diagnosis of EC was established in three patients resulting in a prevalence of 2.2% (3/135) of all patients with SC as well as 30% (3/10) of patients, where no cause of IBS was identified. 2/3 patients with post-hoc diagnosis of EC underwent surgical resection with suspicion for malignancy. Diagnosis of IgG4-related cholangitis was observed in 7/135 patients (5.1%), whereas 3 cases were discovered in post-hoc analysis. 6/7 cases with IgG4-related cholangitis (85.7%) presented with eosinophilic infiltration in addition to IgG4 positive plasma cells. There was no patient with eosinophilic infiltration in the control group of liver transplant donors (n = 27) and patients with primary sclerosing cholangitis (n = 14).
CONCLUSION: EC is an underdiagnosed benign etiology of SC and IBS, which has to be considered in differential diagnosis of IBS.
Metadaten| Author: | Dirk Henning WalterORCiDGND, Sylvia HartmannORCiDGND, Eva HerrmannORCiDGND, Jan Franz-Josef Peveling-OberhagORCiDGND, Wolf Otto BechsteinORCiDGND, Stefan ZeuzemORCiDGND, Martin-Leo HansmannGND, Mireen Friedrich-RustORCiDGND, Jörg Gerhard AlbertORCiDGND |
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| URN: | urn:nbn:de:hebis:30:3-430137 |
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| URL: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5311093 |
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| DOI: | https://doi.org/10.3748/WJG.v23.i6.1044 |
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| ISSN: | 2219-2840 |
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| ISSN: | 1007-9327 |
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| Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/28246478 |
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| Parent Title (English): | World journal of gastroenterology |
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| Publisher: | WJG Press |
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| Place of publication: | Beijing |
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| Document Type: | Article |
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| Language: | English |
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| Date of Publication (online): | 2017/03/09 |
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| Date of first Publication: | 2017/02/14 |
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| Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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| Release Date: | 2017/03/09 |
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| Tag: | IgG4-related disease; Indeterminate biliary stricture; bile duct stenosis; endoscopic retrograde cholangiopancreatography; endoscopy; eosinophilic cholangitis; primary sclerosing cholangitis |
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| Volume: | 23 |
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| Issue: | 6 |
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| Page Number: | 8 |
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| First Page: | 1044 |
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| Last Page: | 1050 |
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| Note: | Copyright © The author(s) 1995-2016. Published by Baishideng Publishing Group Inc. All rights reserved. Articles published by this open-access journal are distributed under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC 4.0) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. |
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| HeBIS-PPN: | 446472883 |
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| Institutes: | Medizin / Medizin |
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| Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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| Sammlungen: | Universitätspublikationen |
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| Licence (English): |  Creative Commons - Namensnennung-Nicht kommerziell 4.0 |
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Creative Commons - Namensnennung-Nicht kommerziell 4.0