{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:45:38Z","timestamp":1783464338137,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>United European Gastroenterology (UEG) Guidelines on immunoglobulin G4 (IgG4)\u2010related digestive disease provides evidence\u2010based recommendations for the diagnosis and management of IgG4\u2010related digestive disease. The aim of this study is to evaluate the adherence to recommendations of this IgG4 guideline across centers in Europe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Questionnaire\u2010based data related to organ involvement, diagnosis, treatment and follow\u2010up of newly diagnosed patients with IgG4\u2010related digestive diseases over a 3\u2010year period, were collected from 14 centers in 11 European countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and ninety\u2010nine patients (76% males) were included. Median age at diagnosis was 64\u00a0years. Most of the patients had concomitant pancreatic and biliary tree involvement (46%), followed by isolated pancreatic involvement (33.5%), isolated biliary tree involvement (18.5%), esophageal involvement (1.5%) or bowel (0.5%) involvement. Most of the patients (64%) underwent a combination of computed tomography and magnetic resonance imaging at diagnosis. Among the 158 autoimmune pancreatitis patients with or without concomitant bile duct involvement, treatment was performed according to guidelines in 115 patients (73%; moderate adherence). Follow\u2010up assessment was performed between 2 and 4\u00a0weeks in 75 patients (47%, partial adherence). Among 37 patients with liver\u2010 or biliary tree involvement, 29 patients were treated according to guidelines (78%; full adherence). In the follow\u2010up of patients with isolated liver\u2010 or biliary tree involvement, we observed moderate adherence in 21 (57%). Disease monitoring for activity and damage using the IgG4 responder activity index was utilized in only 3\/14 centers (poor adherence).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>IgG4\u2010related digestive disease is restricted to the pancreas and bile ducts in the majority of patients. Even in specialist centers with an interest in IgG4\u2010related digestive disease, UEG guideline treatment adherence was moderate, follow\u2010up at 2\u20134\u00a0weeks was only partial, and monitoring for disease activity was poor. These findings highlight the need for ongoing education and improved adherence to monitoring among healthcare providers.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.70081","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T13:13:48Z","timestamp":1753190028000},"page":"1583-1592","source":"Crossref","is-referenced-by-count":3,"title":["Adherence to United European Gastroenterology Guidelines on Diagnosis and Therapy of Immunoglobulin\u2010G4\u2010Related Digestive Disease"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6496-295X","authenticated-orcid":false,"given":"Miroslav","family":"Vujasinovic","sequence":"first","affiliation":[{"name":"Department of Upper Digestive Diseases Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Medicine Huddinge Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4522-2921","authenticated-orcid":false,"given":"Marco","family":"Lanzillotta","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Vita\u2010Salute San Raffaele  Milan Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9644-8392","authenticated-orcid":false,"given":"Emma L.","family":"Culver","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology and Liver Unit John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Medicine University of Oxford  Oxford UK"},{"name":"NIHR Oxford BRC  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0000-4525","authenticated-orcid":false,"given":"Vinciane","family":"Rebours","sequence":"additional","affiliation":[{"name":"Pancreatology and Digestive Oncology Department Beaujon Hospital Universit\u00e9 Paris Cit\u00e9  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-3073","authenticated-orcid":false,"given":"Joost P. 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