{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T05:07:23Z","timestamp":1770440843899,"version":"3.49.0"},"reference-count":7,"publisher":"SMC Media","issue":"2","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Hypertransaminasemia associated with acute abdominal pain can be indicative of a broad spectrum of diseases, from benign to life-threatening. Case description:\u00a0We present the case of a 72-year-old man reporting abdominal pain, unintentional weight loss and moderately elevated liver enzymes. Imaging revealed multisystem involvement including pancreas, biliary tract, thyroid, and salivary and lacrimal glands. Serological tests showed markedly elevated serum IgG4 levels. Histological findings revealed IgG4-positive lymphoplasmacytic infiltrates. In the absence of exclusion criteria, the patient met the 2019 EULAR\/ACR classification criteria for IgG4-related disease (IgG4RD). Discussion:\u00a0IgG4RD is a systemic immune-mediated condition characterised by fibro-inflammatory infiltrates that can mimic malignancies or other autoimmune diseases. Its diagnosis requires an integration of clinical, radiological and histopathological data. Conclusions:\u00a0This case highlights how non-specific findings, such as hypertransaminasaemia and abdominal pain, may hide rare but treatable conditions such as IgG4RD. Early recognition is crucial to initiate immunosuppressive therapy and prevent irreversible organ damage.<\/jats:p>","DOI":"10.12890\/2026_006003","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:12:12Z","timestamp":1769087532000},"source":"Crossref","is-referenced-by-count":0,"title":["Hypertransaminasemia in a patient with acute abdominal pain: an unusual case report"],"prefix":"10.12890","volume":"13","author":[{"given":"Antonia Ida","family":"Facciuto","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmine","family":"Nasta","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Palumbo","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romeo","family":"Morelli","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Finelli","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelia","family":"Marquardt","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Giordano","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"on behalf of the","family":"Hypertransaminasemia Study Group","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"10.12890\/2026_006003_ref1","unstructured":"Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician 2008;77:971\u2013978."},{"key":"10.12890\/2026_006003_ref2","doi-asserted-by":"crossref","unstructured":"Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a guide for clinicians. CMAJ 2005;172:367\u2013379. doi: 10.1503\/cmaj.1040752","DOI":"10.1503\/cmaj.1040752"},{"key":"10.12890\/2026_006003_ref3","doi-asserted-by":"crossref","unstructured":"Wallace ZS, Naden RP, Chari S, Choi H, Della-Torre E, Dicaire JF, et al. American College of Rheumatology\/European League Against Rheumatism IgG4-Related Disease Classification Criteria Working Group. The 2019 American College of Rheumatology\/European League Against Rheumatism classification criteria for IgG4-related disease. Arthritis Rheumatol 2020;72:7\u201319. doi: 10.1002\/art.41120","DOI":"10.1002\/art.41120"},{"key":"10.12890\/2026_006003_ref4","doi-asserted-by":"crossref","unstructured":"Katz G, Stone JH. Clinical perspectives on IgG4-related disease and its classification. Annu Rev Med 2022;73:545\u2013562. doi: 10.1146\/annurev-med-050219-034449","DOI":"10.1146\/annurev-med-050219-034449"},{"key":"10.12890\/2026_006003_ref5","doi-asserted-by":"crossref","unstructured":"Stone JH, Khosroshahi A, Deshpande V, Chan JK, Heathcote JG, Aalberse R, et al. Recommendations for the nomenclature of IgG4-related disease and its individual organ system manifestations. Arthritis Rheum 2012;64:3061\u20133067. doi: 10.1002\/art.34593","DOI":"10.1002\/art.34593"},{"key":"10.12890\/2026_006003_ref6","doi-asserted-by":"crossref","unstructured":"Zhang W, Stone JH. Management of IgG4-related disease. Lancet Rheumatol 2019;1:e55\u2013e65. doi: 10.1016\/S2665-9913(19)30017-7","DOI":"10.1016\/S2665-9913(19)30017-7"},{"key":"10.12890\/2026_006003_ref7","doi-asserted-by":"crossref","unstructured":"Umehara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T, et al. Research program for intractable disease by Ministry of Health, Labor and Welfare (MHLW) Japan G4 team. A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details. 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