Mark Topazian, Thomas E. Witzig, Thomas C. Smyrk, Jose S

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Presentation transcript:

Rituximab Therapy for Refractory Biliary Strictures in Immunoglobulin G4–Associated Cholangitis Mark Topazian, Thomas E. Witzig, Thomas C. Smyrk, Jose S. Pulido, Michael J. Levy, Patrick S. Kamath, Suresh T. Chari Clinical Gastroenterology and Hepatology Volume 6, Issue 3, Pages 364-366 (March 2008) DOI: 10.1016/j.cgh.2007.12.020 Copyright © 2008 AGA Institute Terms and Conditions

Figure 1 (A) Cholangiogram showing hilar biliary strictures before treatment. (B) Progression of strictures after steroid and 6-mercaptopurine therapy. Intrahepatic ducts fill poorly despite occlusion cholangiography. (C) Improvement 4 months after the initiation of rituximab therapy. Clinical Gastroenterology and Hepatology 2008 6, 364-366DOI: (10.1016/j.cgh.2007.12.020) Copyright © 2008 AGA Institute Terms and Conditions

Figure 2 (A) Biliary biopsy specimen showing a lymphoplasmacytic infiltrate. (B) IgG4 stain of the biliary biopsy specimen shows abundant positive plasma cells, consistent with IAC. (C) Pancreas Tru-cut biopsy shows features of chronic pancreatitis with a lymphoplasmacytic infiltration and storiform fibrosis, consistent with AIP. (D) Pancreatic IgG4 stain shows abundant positive plasma cells. Clinical Gastroenterology and Hepatology 2008 6, 364-366DOI: (10.1016/j.cgh.2007.12.020) Copyright © 2008 AGA Institute Terms and Conditions