Purpose:To report a rare case of biliary candidiasis in a host with normal immunity.Methods:Laboratory tests indicated an elevated G level of 1000 pg/ml.Microscopic examination of pathological sections demonstrated mu...Purpose:To report a rare case of biliary candidiasis in a host with normal immunity.Methods:Laboratory tests indicated an elevated G level of 1000 pg/ml.Microscopic examination of pathological sections demonstrated multiple,narrow base,budding yeast cells following Grocott's methenamine silver staining and periodic acid-Schiff staining.Subsequent sequence analysis supported the diagnosis of biliary candidiasis.Results:A 31-year-old previously healthy man developed obstructive jaundice under no obvious inducement.He experienced cholecystectomy and biliary drainage.Surgical specimens revealed granulomatous chronic inflammation in the gallbladder,liver,bile ducts and mesenteric lymph nodes.He was misdiagnosed with tuberculosis and received antituberculosis treatment.However,his condition did not improve.He was finally diagnosed with biliary candidiasis and administered the antifungal treatment with fluconazole.His symptoms improved after such treatment.Conclusions:We reported a case of biliary candidiasis that mimicked IgG4-RD in a host with normal immunity.Our findings highlighted the need for pathological diagnosis in patients with symptoms resembling IgG4-RD.展开更多
Background:Type 1 autoimmune pancreatitis(AIP)is the pancreatic manifestation of IgG4-related disease.However,this benign disease can result in the peripancreatic vascular involvement(PVI)on occasion,which increases t...Background:Type 1 autoimmune pancreatitis(AIP)is the pancreatic manifestation of IgG4-related disease.However,this benign disease can result in the peripancreatic vascular involvement(PVI)on occasion,which increases the difficulty of diagnosis and treatment of this clinical entity as well as for differentiating it from pancreatic malignancies.Methods:We retrospectively reviewed the information on demographics,clinical presentation,laboratory,imaging and endoscopic findings of 101 hospitalized patients with type 1 AIP treated in our department.All the patients were divided into non-PVI and PVI groups according to the first hospitalized medical data.Univariate and multivariate analyses were performed to analyse the potential predictive parameter(s)of PVI in AIP patients.Results:Among the 101 type 1 AIP patients,52(51.5%)exhibited PVI,with a male/female ratio 5.5:1.Their average age was 58.37±8.68 years old.Univariate analysis revealed that the location of pancreatitis lesions,including the pancreatic tail(P=0.010),the presence of splenomegaly(P=0.001)and the white blood cell(WBC)number in peripheral blood(P=0.020),were significantly associated with PVI.The location of pancreatitis lesions,including the pancreatic tail(P=0.023),and the presence of splenomegaly(P=0.010)were found to be independent predictors of the development of PVI by a multivariable regression analysis.A total of 18 out of 25 patients in PVI group who underwent corticosteroid treatment and no less than 6 months radiological follow-up showed improvement in vascular lesions,and no case exhibited exacerbation of PVI lesions during follow-up.Of 36 patients in non-PVI group who were followed up for no less than 6 months,only one case exhibited PVI.Conclusions:This retrospective study demonstrated that type 1 AIP was associated with a high proportion of PVI.Pancreatic tail involvement and splenomegaly may predict the PVI in type 1 AIP.PVI lesions are reversible in a subset of patients.展开更多
基金Capital's Funds for Health Improvement and Research,Grant/Award Number:2022‐2‐2026。
文摘Purpose:To report a rare case of biliary candidiasis in a host with normal immunity.Methods:Laboratory tests indicated an elevated G level of 1000 pg/ml.Microscopic examination of pathological sections demonstrated multiple,narrow base,budding yeast cells following Grocott's methenamine silver staining and periodic acid-Schiff staining.Subsequent sequence analysis supported the diagnosis of biliary candidiasis.Results:A 31-year-old previously healthy man developed obstructive jaundice under no obvious inducement.He experienced cholecystectomy and biliary drainage.Surgical specimens revealed granulomatous chronic inflammation in the gallbladder,liver,bile ducts and mesenteric lymph nodes.He was misdiagnosed with tuberculosis and received antituberculosis treatment.However,his condition did not improve.He was finally diagnosed with biliary candidiasis and administered the antifungal treatment with fluconazole.His symptoms improved after such treatment.Conclusions:We reported a case of biliary candidiasis that mimicked IgG4-RD in a host with normal immunity.Our findings highlighted the need for pathological diagnosis in patients with symptoms resembling IgG4-RD.
基金National Natural Science Foundation of China,Joint Fund Project(grant No.U20A600)National Key R&D Program of China(grant No.2020YFC2002702)+1 种基金National Key Technology Research and Development Program(grant No.2016YFC1302802)Beijing Municipal Science and Technology Project(grant No.Z181100001618013).
文摘Background:Type 1 autoimmune pancreatitis(AIP)is the pancreatic manifestation of IgG4-related disease.However,this benign disease can result in the peripancreatic vascular involvement(PVI)on occasion,which increases the difficulty of diagnosis and treatment of this clinical entity as well as for differentiating it from pancreatic malignancies.Methods:We retrospectively reviewed the information on demographics,clinical presentation,laboratory,imaging and endoscopic findings of 101 hospitalized patients with type 1 AIP treated in our department.All the patients were divided into non-PVI and PVI groups according to the first hospitalized medical data.Univariate and multivariate analyses were performed to analyse the potential predictive parameter(s)of PVI in AIP patients.Results:Among the 101 type 1 AIP patients,52(51.5%)exhibited PVI,with a male/female ratio 5.5:1.Their average age was 58.37±8.68 years old.Univariate analysis revealed that the location of pancreatitis lesions,including the pancreatic tail(P=0.010),the presence of splenomegaly(P=0.001)and the white blood cell(WBC)number in peripheral blood(P=0.020),were significantly associated with PVI.The location of pancreatitis lesions,including the pancreatic tail(P=0.023),and the presence of splenomegaly(P=0.010)were found to be independent predictors of the development of PVI by a multivariable regression analysis.A total of 18 out of 25 patients in PVI group who underwent corticosteroid treatment and no less than 6 months radiological follow-up showed improvement in vascular lesions,and no case exhibited exacerbation of PVI lesions during follow-up.Of 36 patients in non-PVI group who were followed up for no less than 6 months,only one case exhibited PVI.Conclusions:This retrospective study demonstrated that type 1 AIP was associated with a high proportion of PVI.Pancreatic tail involvement and splenomegaly may predict the PVI in type 1 AIP.PVI lesions are reversible in a subset of patients.
