제1형 자가면역성 췌장염에 동반된 진행성 위암 양상의 면역글로불린 G4 연관 위궤양
Immunoglobulin G4-Related Gastric Ulcer Mimicking Advanced Stomach Cancer in a Patient with Type I Autoimmune Pancreatitis
박정하, 노진희, 이장호, 이고은, 홍승모, 조광범, 김명환,
소속 상세정보
박정하 ( Park Joung-Ha )
울산대학교 의과대학 서울아산병원 내과
노진희 ( Noh Jin-Hee )
울산대학교 의과대학 서울아산병원 내과
이장호 ( Lee Jang-Ho )
울산대학교 의과대학 서울아산병원 내과
이고은 ( Lee Go-Eun )
울산대학교 의과대학 서울아산병원 병리과
홍승모 ( Hong Seung-Mo )
울산대학교 의과대학 서울아산병원 병리과
조광범 ( Cho Kwang-Bum )
계명대학교 동산의료원 내과
김명환 ( Kim Myung-Hwan )
울산대학교 의과대학 서울아산병원 내과
Abstract
Type I autoimmune pancreatitis (AIP), a form of chronic pancreatitis, is included within the spectrum of immunoglobulin G4-related diseases (IgG4-RD). IgG4-RD can involve the salivary glands, bile ducts, kidneys and retroperitoneum, and the pancreas, and responds well to corticosteroid treatment. However, gastric involvement in IgG4-RD has been rarely reported. Here we report the case of a 56-year-old man with type I autoimmune pancreatitis who presented with a giant gastric ulcer mimicking advanced gastric cancer, which was subsequently determined to be IgG4-RD. Both the patient’s symptoms and his ulcerative lesions in the stomach responded to steroid treatment, which obviated the need for major surgery such as gastrectomy. Our case demonstrates the importance of recognizing potential gastric involvement in IgG4-RD, especially in a patient with concurrent AIP/IgG4-RD or a history of the disease, who is evaluated for an intractable and/or atypical gastric ulcer. A prompt diagnosis and proper management will avoid unnecessary surgery.
키워드
Gastric ulcer; Pancreatitis; IgG4-related disease
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