Increased Serum IgG4 Levels and Eosinophilia Observed in a Case Study

Overview

This case study presents a 68-year-old man with a persistent indeterminate biliary stricture characterized by elevated serum IgG4 and eosinophilia. Corticosteroid treatment led to laboratory improvements, but the anatomical stenosis persisted.

Background

Indeterminate biliary strictures pose a significant diagnostic challenge as they can arise from various conditions, including inflammatory diseases and malignancies. The overlapping clinical and serologic features complicate the differentiation between benign and malignant etiologies.

Data Highlights

No numerical data or trial data available in the article.

Key Findings

• A 68-year-old man presented with progressive jaundice and cholestatic liver injury.
• Laboratory tests revealed marked eosinophilia and elevated serum IgG4 levels.
• Imaging showed an indeterminate common bile duct stricture with upstream biliary dilatation.
• Pathology indicated chronic inflammation with eosinophils but negative IgG4 staining.
• Despite corticosteroid treatment, anatomical stenosis persisted, prompting further malignancy assessment.

Clinical Implications

The persistence of anatomical stenosis despite laboratory improvements indicates the need for careful evaluation in patients with indeterminate biliary strictures.

Conclusion

This case highlights the complexity of diagnosing indeterminate biliary strictures.

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