ArticleFrontiers in immunology2026
Case Report: A steroid-sparing mechanical management of IgG4-related sclerosing cholangitis mimicking cholangiocarcinoma.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: IgG4-SC typically requires long-term corticosteroid therapy. We report a distinctive case of a 65-year-old woman with biopsy-supported IgG4-SC that closely mimicked malignancy. Case summary: The patient presented with 10 kg weight loss and CA19-9 of 315 U/mL. She achieved sustained clinical and biochemical remission after repeated endoscopic mechanical decompression alone, with no recurrent obstructive cholestasis during long-term clinical and biochemical follow-up. However, serum IgG4 remained elevated at long-term reassessment, and complete immunologic remission could not be assumed. Conclusion: This case raises the possibility of an "obstruction-dominant" presentation of IgG4-SC and suggests that intensive endoscopic biliary decompression may serve as a temporary or, in selected cases, sustained steroid-sparing strategy in carefully selected high-risk patients, without challenging the current role of corticosteroids as standard first-line therapy.
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