{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T10:13:06Z","timestamp":1788603186724,"version":"build-2803163510"},"reference-count":0,"publisher":"Greater Baltimore Medical Center","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Community Hospital Internal Medicine Perspectives"],"abstract":"<jats:p>Background: IgG4-related sclerosing cholangitis (IgG4-SC) is a rare immune-mediated disorder affecting the biliary tree and leading to biliary strictures that may resemble cholangiocarcinoma (CCA).\nCase Presentation: An elderly man presented with a one-week history of jaundice, pale stool, and dark urine. This was associated with unintentional weight loss over the past year. Laboratory findings were notable for cholestasis and significantly elevated CA19-9. Imaging demonstrated multiple diffuse biliary strictures of malignant appearance. Cytology showed atypical glandular cells. The patient was misdiagnosed with CCA and was assessed for a possible surgical intervention or chemoradiotherapy. However, the patient was eventually diagnosed with IgG4-SC after a high serum IgG4 level and liver biopsy. The patient responded well to steroids.\nConclusion: This case underscores the diagnostic dilemma posed by IgG4-SC, particularly in elderly patients with cholestatic jaundice and elevated CA 19-9, which can be misleading for malignancy.<\/jats:p>","DOI":"10.55729\/2000-9666.1590","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T01:13:38Z","timestamp":1773882818000},"page":"45-49","source":"Crossref","is-referenced-by-count":0,"title":["IgG4-Related Sclerosing Cholangitis Masquerading as Cholangiocarcinoma: A Diagnostic Challenge"],"prefix":"10.55729","volume":"16","author":[{"given":"Shahem","family":"Abbarh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, MedStar Health, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bisher","family":"Sawaf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhika","family":"Vij","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, MedStar Health, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoko","family":"Oshima","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Liver Pathology, Johns Hopkins University, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichi","family":"Kinowaki","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Liver Pathology, Johns Hopkins University, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Sankineni","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, MedStar Health, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"34701","published-online":{"date-parts":[[2026,3,17]]},"container-title":["Journal of Community Hospital Internal Medicine Perspectives"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:53:32Z","timestamp":1788602012000},"score":1,"resource":{"primary":{"URL":"https:\/\/scholarlycommons.gbmc.org\/jchimp\/vol16\/iss2\/8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,3,17]]}},"URL":"https:\/\/doi.org\/10.55729\/2000-9666.1590","relation":{},"ISSN":["2000-9666"],"issn-type":[{"value":"2000-9666","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}