Küttner's Tumor and Autoimmune Pancreatitis as Metachronous Manifestations of IgG4-Related Disease

J Investig Med High Impact Case Rep. 2024 Jan-Dec:12:23247096241286368. doi: 10.1177/23247096241286368.

Abstract

Immunoglobulin G4-related disease (IgG4-RD) is a multiorgan, fibro-inflammatory condition that presents with painless organ swelling, lymphoplasmacytic infiltration, and obliterative phlebitis, often showing a favorable response to corticosteroid therapy. The most affected organs include the pancreas, kidneys, retroperitoneum, lacrimal glands, and salivary glands. Diagnosis relies on serological, imaging, and histopathological findings, with glucocorticoids as the primary treatment. Despite its reversible nature and good prognosis in many cases, long-term complications such as organ dysfunction or malignancy can still occur. International collaborative efforts have enhanced the understanding, diagnosis, and management of IgG4-RD, emphasizing the importance of comprehensive diagnostic criteria and appropriate therapeutic strategies. Herein, we present an interesting case of a geriatric male who was referred to our clinic because of concern for pancreatic cancer. We diagnosed the patient with autoimmune pancreatitis, a manifestation of IgG4-RD. The patient experienced a dramatic response to steroid therapy and is currently on maintenance therapy.

Keywords: IgG4; IgG4-RD; Küttner’s tumor; autoimmune pancreatitis type 1; chronic sclerosing sialadenitis; immunoglobulin G4-related disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoimmune Pancreatitis* / drug therapy
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G4-Related Disease* / complications
  • Immunoglobulin G4-Related Disease* / diagnosis
  • Immunoglobulin G4-Related Disease* / drug therapy
  • Immunoglobulin G4-Related Disease* / pathology
  • Male
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / pathology
  • Tomography, X-Ray Computed

Substances

  • Glucocorticoids
  • Immunoglobulin G