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A Rare Cause of Abdominal Pain: IgG4-Related Sclerosing Mesenteritis

dc.contributor.authorPedroto, Isabel
dc.contributor.authorCarvalho Sá, Diogo
dc.contributor.authorFonseca, Tomás
dc.contributor.authorPereira-Guedes, Tiago
dc.contributor.authorArcher, Sara
dc.date.accessioned2024-07-18T14:44:46Z
dc.date.available2024-07-18T14:44:46Z
dc.date.issued2023-06
dc.description.abstractA 67-year-old man with previous cardiovascular disease was referred to our consultation due to a 5-month history of recurrent epigastric pain. Esophagogastroduodenoscopy and full blood workup presented no alterations. CT scan showed an irregularly shaped mass at the root of the mesentery, measuring 40x25x47mm, with spiculated contours and retractile behaviour (a). Simultaneous densification of the adjacent fat and infracentimetric ganglionic formations scattered throughout the mesentery were shown. Surgical biopsy revealed extensive storiform fibrosclerosis, with the presence of interstitial lymphoplasmocytic infiltrate and obliterative phlebitis (b); the plasma cells had mostly IgG expression, with IgG4:IgG ratio >40% (c), accounting for more than 30- 40 IgG4 plasma cells per field. The serum IgG4 level was 137mg/dL. A diagnosis of IgG4-related sclerosing mesenteritis was made, without other organ involvement. Prednisolone (0.6mg/kg/d) improved partially the abdominal pain, so steroid sparing strategy with off-label rituximab was associated. Due to its low prevalence, the understanding of this entity is scarce, and its diagnosis is challenging. Unlike other manifestations of IgG4-related disease, the intra-abdominal disease is identified in later stages, due to unspecific symptoms. This case aims to raise awareness about this condition as a differential diagnosis of abdominal pain.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationArcher S, Pereira-Guedes T, Fonseca T, Carvalho Sá D, Pedroto I. A Rare Cause of Abdominal Pain: IgG4-Related Sclerosing Mesenteritis. J Gastrointestin Liver Dis. 2023;32(2):141. doi:10.15403/jgld-4921pt_PT
dc.identifier.doi10.15403/jgld-4921pt_PT
dc.identifier.issn1841-8724
dc.identifier.issn1842-1121
dc.identifier.urihttp://hdl.handle.net/10400.16/3007
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherEditura Medicală Universitară "Iuliu Haţieganupt_PT
dc.relation.publisherversionhttps://jgld.ro/jgld/index.php/jgld/article/view/4921pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.titleA Rare Cause of Abdominal Pain: IgG4-Related Sclerosing Mesenteritispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceRomaniapt_PT
oaire.citation.endPage141pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage141pt_PT
oaire.citation.titleJournal of Gastrointestinal and Liver Diseasespt_PT
oaire.citation.volume32pt_PT
person.familyNamePedroto
person.givenNameIsabel
person.identifier.orcid0000-0001-6573-699X
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicatione523f164-bf0d-4248-8069-53df9d926349
relation.isAuthorOfPublication.latestForDiscoverye523f164-bf0d-4248-8069-53df9d926349

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