Marked accumulation of fluorodeoxyglucose and inflammatory cells expressing glucose transporter‐3 in immunoglobulin G4‐related autoimmune hepatitis

Immunoglobulin (Ig)G4‐related autoimmune hepatitis (AIH) is a recently proposed subtype that responds well to steroid treatment; however, its pathogenesis remains unclear. We report here a 65‐year‐old Japanese woman with skin itching and lip swelling. She had liver injury with jaundice, which persis...

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Published inHepatology research Vol. 48; no. 11; pp. 937 - 944
Main Authors Araki, Toshihiro, Arinaga‐Hino, Teruko, Koga, Hironori, Akiba, Jun, Ide, Tatsuya, Okabe, Yoshinobu, Kuwahara, Reiichiro, Amano, Keisuke, Yasumoto, Makiko, Kawaguchi, Toshihiro, Sano, Tomoya, Kondou, Reiichiro, Kurata, Seiji, Mitsuyama, Keiichi, Torimura, Takuji
Format Journal Article
LanguageEnglish
Published Hoboken Wiley Subscription Services, Inc 01.10.2018
Subjects
AIH
Biopsy
Computed tomography
double immunofluorescence staining
FDG‐PET/CT
Glucose transporter
glucose transporter (Glut)
Hepatitis
IgG4‐related AIH
IgG4‐related disease
Immunofluorescence
Immunoglobulin G
Immunoglobulin G4
Immunoglobulins
Inflammation
Jaundice
Liver
Lymph nodes
Pathogenesis
Positron emission tomography
Pruritus
Salivary gland
Skin
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Summary:Immunoglobulin (Ig)G4‐related autoimmune hepatitis (AIH) is a recently proposed subtype that responds well to steroid treatment; however, its pathogenesis remains unclear. We report here a 65‐year‐old Japanese woman with skin itching and lip swelling. She had liver injury with jaundice, which persisted despite stopping anti‐allergic agents. Blood chemistry revealed highly elevated serum IgG and IgG4 (535 mg/dL) levels, and positive anti‐nuclear antibody. The diagnosis of AIH was based on liver biopsy. Notably, the IgG4+/IgG+ cell ratio was 85%. On fluorodeoxyglucose (FDG) positron emission tomography/computed tomography, robust signal intensity was found in the liver, and in enlarged lymph nodes and salivary glands with confirmed IgG4+ cell infiltration. Immunofluorescence analysis of the liver biopsy specimen indicated clear expression of glucose transporter‐3 (Glut‐3) in IgG4+ inflammatory cells infiltrating into the portal area. This is the first report of simultaneous strong accumulation of FDG and Glut‐3 expression in IgG4‐related AIH, which might aid in elucidating the pathogenesis of this disease.
Bibliography:The authors have no conflict of interest.
Conflict of interest
Financial support
None declared.
ISSN:1386-6346
1872-034X
DOI:10.1111/hepr.13188