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Journal of Crohn's and Colitis: 9 (12)


Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium


Published on behalf of

The successful treatment of IgG4-positive colitis with adalimumab in a patient with IgG4-related sclerosing disease – a new subtype of aggressive colitis?

Mani Naghibi, Adil Ahmed, Adnan M. al Badri, Adrian C. Bateman, Hugh A. Shepherd, John N. Gordon
DOI: http://dx.doi.org/10.1016/j.crohns.2012.05.003 e81-e84 First published online: 1 April 2013


We present the case of a 16 year old girl who developed an aggressive colitis in the context of a prior biopsy proven autoimmune pancreatitis, which presented with obstructive jaundice at the age of 13 year. This history prompted prospective investigation and the discovery of compelling evidence to make a diagnosis of IgG4-related sclerosing disease with extra-pancreatic colonic involvement on the basis of raised serum IgG4 levels and a florid colonic IgG4 plasma cell infiltrate with over 20 IgG4 positive plasma cells/hpf. The colitis was resistant to conventional therapy but responded dramatically to treatment with the anti-TNFα monoclonal antibody, adalimumab. This is the first case to report both the effectiveness of adalimumab in treating IgG4 positive colitis in a patient with IgG4-related sclerosing disease, and to prospectively record resolution of an IgG4 positive colonic infiltrate with immunosuppression.

  • Colitis
  • Adalimumab
  • IgG4 sclerosing disease
  • Pancreatitis
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