Yin ML, Ma GD, Gan YQ, Li P, Zhang ZD, Zhang SB, Meng Q, Liu B, Zhao SY. Immunoglobulin G4-related disease requiring clinical attention: A case report and review of literature. World J Gastroenterol 2025; 31(38): 110645 [DOI: 10.3748/wjg.v31.i38.110645]
Corresponding Author of This Article
Shou-Ye Zhao, MM, Doctor, Department of Hepatobiliary Surgery, Affiliated Hospital of Jining Medical University, Jining Medical University, No. 89 Guhuai Road, Jining 272000, Shandong Province, China. zhaoshouye@mail.jnmc.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ming-Li Yin, Guo-Dong Ma, Peng Li, Zai-Dong Zhang, Qiang Meng, Biao Liu, Shou-Ye Zhao, Department of Hepatobiliary Surgery, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272000, Shandong Province, China
Yan-Qing Gan, Department of Cardiac Surgery, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining 272000, Shandong Province, China
Shu-Bin Zhang, Department of Surgical, Sishui County Maternal and Child Health Family Planning Service Center, Jining 273200, Shandong Province, China
Co-first authors: Ming-Li Yin and Guo-Dong Ma.
Author contributions: Yin ML and Ma GD were responsible for patient management, treatment, manuscript drafting, and data curation; Gan YQ and Zhang SB were in charge of data management and literature retrieval; Li P, Zhang ZD, Meng Q and Liu B participated in the entire treatment process of the patients; Zhao SY supervised the overall therapeutic strategy and manuscript review; All authors have read and approved the final manuscript.
Supported by the National Natural Science Foundation of Shandong Province, No. ZR2019QH008.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shou-Ye Zhao, MM, Doctor, Department of Hepatobiliary Surgery, Affiliated Hospital of Jining Medical University, Jining Medical University, No. 89 Guhuai Road, Jining 272000, Shandong Province, China. zhaoshouye@mail.jnmc.edu.cn
Received: June 24, 2025 Revised: July 27, 2025 Accepted: September 3, 2025 Published online: October 14, 2025 Processing time: 113 Days and 6.1 Hours
Abstract
BACKGROUND
Immunoglobulin G4 (IgG4)-related disease (IgG4-RD), a relatively rare immune-mediated chronic inflammatory condition characterized by fibrosis, is capable of affecting multiple organs and systems. Epidemiologically, the disease predominantly affects middle-aged and older men in Asian populations, whereas it shows a female predominance in the corresponding age group in the United States. In IgG4-RD, affected tissues and organs may exhibit diffuse or localized swelling, mimicking neoplastic lesions. IgG4-related cholecystitis (IgG4-CC) represents a manifestation involving the gallbladder, with isolated gallbladder involvement without other organ lesions being exceptionally uncommon.
CASE SUMMARY
A 53-year-old man was admitted to the hospital with abdominal pain. Preoperative evaluations could not exclude gallbladder carcinoma, and surgical intervention was required. Based on intraoperative findings, postoperative pathology, and postoperative serum IgG4 levels, a diagnosis of IgG4-CC was considered. After glucocorticoid therapy, the patient’s general condition substantially improved.
CONCLUSION
For patients present with space-occupying lesions of the gallbladder, IgG4-RD should be included in the differential diagnosis.
Core Tip: This article describes a case of immunoglobulin G4 (IgG4)-related cholecystitis (IgG4-CC) in a patient who presented solely with abdominal pain, no pancreatic or biliary duct involvement was evident. Such an isolated occurrence of IgG4-CC is rare because IgG4-CC represents only one manifestation of IgG4-related disease (IgG4-RD). The clinical presentation of IgG4-RD is complex and highly variable, potentially affecting single or multiple organs and tissues, which increases the risks of misdiagnosis and missed diagnosis in clinical practice. For hepatobiliary and pancreatic surgeons, greater awareness of IgG4-RD is essential to avoid unnecessary surgical interventions.
