A Case of IgG4-Related Disease with Duodenitis That Was Difficult to Diagnose Preoperatively

Q: What does this research mean for the field?

IgG4-related disease can present as duodenitis with deep submucosal inflammation and storiform fibrosis, which may be difficult to diagnose preoperatively due to normal serum IgG4 levels and non-diagnostic superficial biopsies. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Junichi Okada; Keiichi Suzuki; Masayoshi Monno; Kenshi Omagari; Takeo Hashimoto; Masafumi Nishikawa

doi:10.5833/jjgs.2025.0013

May 1, 2026The Japanese Journal of Gastroenterological SurgeryOpen Access

A Case of IgG4-Related Disease with Duodenitis That Was Difficult to Diagnose Preoperatively

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Key Points

To report a challenging case of IgG4-related disease presenting as duodenitis with atypical diagnostic findings.
Clinical examination of a 48-year-old female with chronic abdominal pain.
Upper gastrointestinal endoscopy and imaging tests, including EUS-FNA and contrast-enhanced CT, were performed.
Pathological examination of biopsy samples was conducted post-surgery.
Identified moderate inflammation and storiform fibrosis in duodenal tissue after surgical intervention.
Preoperative tests showed normal IgG4 levels and no detectable IgG4-positive plasma cell infiltration.
Chronic pancreatitis was initially diagnosed based on imaging, leading to surgical treatment.

Implication

Case report of a difficult-to-diagnose IgG4-related disease causing duodenitis, highlighting clinical and pathological features.

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Cite This Study

Okada et al. (2026) studied this question.

synapsesocial.com/papers/6a1bd0155783ba022b6fbe62 https://doi.org/10.5833/jjgs.2025.0013

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A Case of IgG4-Related Disease with Duodenitis That Was Difficult to Diagnose Preoperatively

Key Points

Implication

Abstract

Discussion

Cite This Study

A Case of IgG4-Related Disease with Duodenitis That Was Difficult to Diagnose Preoperatively

Key Points

Implication

Abstract

Discussion

Cite This Study

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