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Gastrointestinal Imaging

E2905. The Many Faces of IgG4 Related Disease

Brown A,  Helmly B. Memorial Health University Medical Center, Savannah, Georgia

Address correspondence to A. Brown (

Background Information: IgG4 related disease was named a systemic disease in 2003 and is an autoimmune/allergic disorder that results from lymphoplasmacytic infiltration of IgG4 positive cells into multiple organs and soft tissues. The pancreas is most commonly involved; however, multiple organs can be impacted 60-90% of the time. Due to the rapid response of treatment from corticosteroid therapy, it is important to ensure Radiologists and referring physicians are aware of the wide variety of manifestations that can occur with this disease process.

Educational Goals/Teaching Points: Case based presentation to review imaging findings of the most common manifestations IgG4 related disease.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: CT and MRI imaging findings associated with IgG4 related disease to include: Autoimmune pancreatitis, Sclerosing Cholangitis, Salivary gland involvement, Orbital and Lacrimal gland involvement, Retroperitoneal fibrosis, Renal manifestations, Sclerosing mesenteritis

Conclusion: IgG4 related disease is a systemic process that manifests in many different organ systems and can be a diagnostic dilemma for many clinicians. The knowledge gained from this review of the common imaging manifestations will remind our Radiology colleagues about this disease process which in turn will bolster our referring physician’s clinical acumen and improve the care for our patients.