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Medline ® Abstract for Reference 71

of 'Autoimmune pancreatitis'

Rituximab therapy for refractory biliary strictures in immunoglobulin G4-associated cholangitis.
Topazian M, Witzig TE, Smyrk TC, Pulido JS, Levy MJ, Kamath PS, Chari ST
Clin Gastroenterol Hepatol. 2008;6(3):364.
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.
Miles and Shirley Fiterman Center for Digestive Diseases, Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55906, USA. topazian.mark@mayo.edu