Rituximab Therapy for Refractory Biliary Strictures in Immunoglobulin G4-Associated Cholangitis

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Abstract

Background & Aims: Biliary strictures occur in a third of patients with autoimmune pancreatitis and have been termed immunoglobulin G subclass 4 (IgG4) associated cholangitis (IAC). IAC often responds to steroid therapy. Methods: A patient with autoimmune pancreatitis and (IAC) refractory to steroids and 6-mercaptopurine was treated with rituximab, a monoclonal antibody directed against the CD20 antigen on B lymphocytes. Results: The patient's biliary strictures improved after rituximab therapy, permitting removal of his biliary stents. Systemic manifestations of IgG4-associated disease also improved. Conclusions: Rituximab may be a treatment option for patients with refractory or recurrent autoimmune pancreatitis or IAC.

Original languageEnglish (US)
Pages (from-to)364-366
Number of pages3
JournalClinical Gastroenterology and Hepatology
Volume6
Issue number3
DOIs
StatePublished - Mar 2008

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Cholangitis
Immunoglobulins
Pathologic Constriction
Immunoglobulin G
Pancreatitis
CD20 Antigens
Steroids
Therapeutics
6-Mercaptopurine
Stents
B-Lymphocytes
Monoclonal Antibodies
Rituximab

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Rituximab Therapy for Refractory Biliary Strictures in Immunoglobulin G4-Associated Cholangitis",
abstract = "Background & Aims: Biliary strictures occur in a third of patients with autoimmune pancreatitis and have been termed immunoglobulin G subclass 4 (IgG4) associated cholangitis (IAC). IAC often responds to steroid therapy. Methods: A patient with autoimmune pancreatitis and (IAC) refractory to steroids and 6-mercaptopurine was treated with rituximab, a monoclonal antibody directed against the CD20 antigen on B lymphocytes. Results: The patient's biliary strictures improved after rituximab therapy, permitting removal of his biliary stents. Systemic manifestations of IgG4-associated disease also improved. Conclusions: Rituximab may be a treatment option for patients with refractory or recurrent autoimmune pancreatitis or IAC.",
author = "Mark Topazian and Witzig, {Thomas Elmer} and Smyrk, {Thomas Christopher} and Pulido, {Jose S} and Levy, {Michael J.} and Kamath, {Patrick Sequeira} and Chari, {Suresh T}",
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T1 - Rituximab Therapy for Refractory Biliary Strictures in Immunoglobulin G4-Associated Cholangitis

AU - Topazian, Mark

AU - Witzig, Thomas Elmer

AU - Smyrk, Thomas Christopher

AU - Pulido, Jose S

AU - Levy, Michael J.

AU - Kamath, Patrick Sequeira

AU - Chari, Suresh T

PY - 2008/3

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AB - Background & Aims: Biliary strictures occur in a third of patients with autoimmune pancreatitis and have been termed immunoglobulin G subclass 4 (IgG4) associated cholangitis (IAC). IAC often responds to steroid therapy. Methods: A patient with autoimmune pancreatitis and (IAC) refractory to steroids and 6-mercaptopurine was treated with rituximab, a monoclonal antibody directed against the CD20 antigen on B lymphocytes. Results: The patient's biliary strictures improved after rituximab therapy, permitting removal of his biliary stents. Systemic manifestations of IgG4-associated disease also improved. Conclusions: Rituximab may be a treatment option for patients with refractory or recurrent autoimmune pancreatitis or IAC.

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