Complemental Diagnosis of IgG4-Related Pancreaticobiliary Diseases by Multiple Hypoechoic Lesions in the Submandibular Glands

Naruki Shimamura; Shinichi Takano; Mitsuharu Fukasawa; Makoto Kadokura; Hiroko Shindo; Ei Takahashi; Sumio Hirose; Yoshimitsu Fukasawa; Satoshi Kawakami; Hiroshi Hayakawa; Natsuhiko Kuratomi; Hiroyuki Hasegawa; Shota Harai; Dai Yoshimura; Naoto Imagawa; Tatsuya Yamaguchi; Taisuke Inoue; Shinya Maekawa; Tadashi Sato; Nobuyuki Enomoto

doi:10.3390/jcm11144189

Journal of Clinical Medicine (Jul 2022)

Complemental Diagnosis of IgG4-Related Pancreaticobiliary Diseases by Multiple Hypoechoic Lesions in the Submandibular Glands

Naruki Shimamura,
Shinichi Takano,
Mitsuharu Fukasawa,
Makoto Kadokura,
Hiroko Shindo,
Ei Takahashi,
Sumio Hirose,
Yoshimitsu Fukasawa,
Satoshi Kawakami,
Hiroshi Hayakawa,
Natsuhiko Kuratomi,
Hiroyuki Hasegawa,
Shota Harai,
Dai Yoshimura,
Naoto Imagawa,
Tatsuya Yamaguchi,
Taisuke Inoue,
Shinya Maekawa,
Tadashi Sato,
Nobuyuki Enomoto

Affiliations

Naruki Shimamura: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Shinichi Takano: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Mitsuharu Fukasawa: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Makoto Kadokura: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Hiroko Shindo: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Ei Takahashi: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Sumio Hirose: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Yoshimitsu Fukasawa: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Satoshi Kawakami: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Hiroshi Hayakawa: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Natsuhiko Kuratomi: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Hiroyuki Hasegawa: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Shota Harai: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Dai Yoshimura: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Naoto Imagawa: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Tatsuya Yamaguchi: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Taisuke Inoue: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Shinya Maekawa: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Tadashi Sato: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan
Nobuyuki Enomoto: First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo 409-3898, Yamanashi, Japan

DOI: https://doi.org/10.3390/jcm11144189
Journal volume & issue: Vol. 11, no. 14
p. 4189

Abstract

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The diagnosis of autoimmune pancreatitis (AIP) and immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) may require a somewhat invasive pathological examination and steroid responsiveness. This retrospective study assessed the complemental diagnosis of AIP and IgG4-SC using submandibular gland (SG) ultrasonography (US) in 69 patients, including 54 patients with AIP, 2 patients with IgG4-SC, and 13 patients with both AIP and IgG4-SC. The data from the physical examination and US of SGs to diagnose AIP (n = 67) and IgG4-SC (n = 15) were analyzed. The steroid therapy efficacy in resolving hypoechoic lesions in SGs was evaluated in 36 cases. The presence of IgG4-related pancreaticobiliary disease with multiple hypoechoic lesions in SGs was reduced from 31 to 11 cases after steroid therapy, suggesting that multiple hypoechoic lesions in SGs are strongly associated with IgG4-positive cell infiltrations. Multiple hypoechoic lesions in SGs were observed in 53 cases, whereas submandibular swelling on palpation was observed in 21 cases of IgG4-related pancreaticobiliary diseases. A complemental diagnosis of IgG4-related pancreaticobiliary diseases without a histological diagnosis and steroid therapy was achieved in 57 and 68 cases without and with multiple hypoechoic lesions in SGs, respectively. In conclusion, multiple hypoechoic lesions in SGs are useful for the complemental diagnosis of IgG4-related pancreaticobiliary diseases.

Published in Journal of Clinical Medicine

ISSN: 2077-0383 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.mdpi.com/journal/jcm

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