Multiple intrahepatic artery aneurysms during the treatment for IgG4-related sclerosing cholangitis: A case report

Table 1 Laboratory findings about hematologic test, chemistry and coagulation

Lab investigation	Value
Hematologic test
White blood cells (/μL)	9200
Neutrophil (%)	91.7
Lymphocyte (%)	4.3
Monocyte (%)	3.7
Eosinophil (%)	0.2
Basophil (%)	0.1
Red blood cells (/μL)	279 × 104
MCV (fL)	105.7
MCH (pg)	32.6
MCHC (g/dL)	30.8
Hemoglobin (g/dL)	9.1
Platelet count (/μL)	21.2 × 104
Coagulation
PT (second)	18.6
PT (%)	51.3
PT-INR	1.53
APTT	35.6
Chemistry
AST (U/L)	41
ALT (U/L)	52
LD (U/L)	235
ALP (U/L)	195
γ-GT (U/L)	122
AMY (U/L)	89
Lipase (U/L)	17.2
Total bilirubin (mg/dL)	4.6
Direct bilirubin (mg/dL)	2.2
Total protein (g/dL)	5.95
Albumin (g/dL)	2.54
BUN (mg/dL)	11.3
Creatinine (mg/dL)	0.83
Sodium (mmol/L)	136
Potassium (mmol/L)	4.1
Chloride (mmol/L)	93
CRP (mg/dL)	5.22
Glucose (mg/dL)	158
P-ANCA (EU)	1.3
C-ANCA	1.0
IgG (mg/dL)	1685
IgG4 (mg/dL)	44.4

MCV: Mean corpuscular volume; MCH: Mean corpuscular hemoglobin; MCHC: Mean corpuscular hemoglobin concentration; PT: Prothrombin time; APTT: Activated partial thromboplastin time; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; LD: Lactate dehydrogenase; ALP: Alkaline phosphatase; γ-GT: γ-glutamyl transpeptidase; AMY: Amylase; BUN: Blood urea nitrogen; CRP: C-reactive protein; ANCA: Anti-neutrophil cytoplasmic antibody.

Table 2 Case of hepatic artery aneurysms with IgG4-related disease

Ref.	Age	Sex	Arteriosclerosis exacerbating factors	IgG4-related lesions in other organs	Localization of aneurysm	Size of aneurysm	Treatment	Outcome
Vlachou et al[9], 2011	46	Female	ND	ND	Common hepatic artery	ND	ND	ND
Vlachou et al[9], 2011	ND	ND	ND	ND	Hepatic artery	ND	ND	ND
Yadav et al[6], 2021	55	Male	Hypertension	Paravertebral soft- tissue thickening	Left anterior descending artery Right intercostal artery Common hepatic artery Inferior pancreaticoduodenal artery Superior mesenteric artery	ND	Surgery	Aneurysms were cured. The patient was put on corticosteroids therapy
Kasa et al[7], 2024	49	Male	Current smoker Hypertension Dyslipidemia	None	Common hepatic artery	30 mm	Surgery	Aneurysm were cured, but recurred at a left internal iliac artery and right renal artery
Present case	64	Female	High doses of glucocorticoids for an extended period	Cholangitis retroperitoneal fibrosis	Intrahepatic arteries	20 mm, 7 mm, and 4 mm	Transarterial embolization	Aneurysms were cured, but liver failure developed

ND: Not described.