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IgG4-RD Case Conversations: Diagnosing Pancreaticobiliary Manifestations and Ruling Out Malignancy

15 minutes
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  • Overview

    Painless jaundice is the most common presentation of type 1 autoimmune pancreatitis (AIP), which is a pancreaticobiliary manifestation of IgG4-related disease. In this case, Drs. Yasmin Genevieve Hernandez-Barco and Avinash Kambadakone-Ramesh discuss how a patient presenting to the ER with signs of pancreatic cancer was ultimately diagnosed with type 1 AIP by integrating a constellation of serologic, histopathologic, and radiologic findings. While steroids and immunosuppressive therapies are effective treatment options for IgG4-RD, this case demonstrates that patients with high risk for relapse may benefit from B cell depleting agents as first-line therapy.

  • Disclosure of Conflicts of Interest

    DISCLOSURE POLICY
    It is the policy of Evolve that faculty and other individuals who are in the position to control the content of this activity disclose any real or apparent financial relationships relating to the topics of this educational activity. Evolve has full policies in place that will identify and mitigate all financial relationships prior to this educational activity.

    The following faculty/staff members have the following financial relationships with ineligible companies.

    Yasmin Genevieve Hernandez-Barco, MD, has had a financial relationship or affiliation with the following ineligible companies in the form of Consultant: Amgen and Nestle Health Science. Grant/Research Support: Nestle Health Science and PACT-CP Registry

    Avinash Kambadakone-Ramesh, MD, DNB, FRCR, has had a financial relationship or affiliation with the following ineligible companies in the form of Consultant: Bayer. Grant/Research Support: Bayer, GE HealthCare, and PanCAN.

    The Evolve staff, planners, and peer reviewer have no financial relationships with ineligible companies.

  • Learning Objectives

    Upon completion of this activity, the participant should be able to

    • Identify the individual organ manifestations/clinical features that may support a diagnosis of IgG4-related disease
    • Outline the diseases and/or conditions whose manifestations have substantial overlap with IgG4-RD
  • Target Audience

    This certified continuing education activity is designed for rheumatologists, nurse practitioners, and physician assistants, as well as pathologists and radiologists who diagnose and treat patients involved in the diagnosis and management of IgG4-related disease.

  • Accreditation and Credit Designation Statements

    Provided by Evolve Medical Education 

    Evolve is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
    Evolve designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The American Medical Association has an agreement of mutual recognition of Continuing Medical Education (CME) credits with the European Union of Medical Specialists (UEMS), the accreditation body for European countries. Physicians interested in converting AMA PRA Category 1 Credit™ to UEMS-European Accreditation Council for Continuing Medical Education CME credits (ECMEC®s) should contact the UEMS at mutualrecognition@uems.eu.

  • Provider(s)/Educational Partner(s)

    Evolve Medical Education LLC (Evolve) is a leader in cultivating health care for patients by educating clinical competence of the health care team. Evolve achieves this by developing and distributing high-quality, evidence-based, valid, independent CME/CE activities in a variety of learning formats. These activities are designed to increase clinician’s knowledge, skills, competence and professional performance as well as to promote professional growth, maintenance of licensure, and support quality change in care of patients.

  • Commercial Support

    This activity is supported by an independent medical education grant from Amgen.

  • Disclaimer

    OFF-LABEL STATEMENT
    This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

    DISCLAIMER
    The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Evolve or Amgen.

    This activity is designed for educational purposes. Participants have a responsibility to utilize this information to enhance their professional development to improve patient outcomes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use. 

  • System Requirements

    • Supported Browsers (2 most recent versions):
      • Google Chrome for Windows, Mac OS, iOS, and Android
      • Apple Safari for Mac OS and iOS
      • Mozilla Firefox for Windows, Mac OS, iOS, and Android
      • Microsoft Edge for Windows
    • Recommended Internet Speed: 5Mbps+

  • Publication Dates

    Release Date:

    Expiration Date:

Recommended
Details
Presenters
Related
Comments
  • Overview

    Painless jaundice is the most common presentation of type 1 autoimmune pancreatitis (AIP), which is a pancreaticobiliary manifestation of IgG4-related disease. In this case, Drs. Yasmin Genevieve Hernandez-Barco and Avinash Kambadakone-Ramesh discuss how a patient presenting to the ER with signs of pancreatic cancer was ultimately diagnosed with type 1 AIP by integrating a constellation of serologic, histopathologic, and radiologic findings. While steroids and immunosuppressive therapies are effective treatment options for IgG4-RD, this case demonstrates that patients with high risk for relapse may benefit from B cell depleting agents as first-line therapy.

  • Disclosure of Conflicts of Interest

    DISCLOSURE POLICY
    It is the policy of Evolve that faculty and other individuals who are in the position to control the content of this activity disclose any real or apparent financial relationships relating to the topics of this educational activity. Evolve has full policies in place that will identify and mitigate all financial relationships prior to this educational activity.

    The following faculty/staff members have the following financial relationships with ineligible companies.

    Yasmin Genevieve Hernandez-Barco, MD, has had a financial relationship or affiliation with the following ineligible companies in the form of Consultant: Amgen and Nestle Health Science. Grant/Research Support: Nestle Health Science and PACT-CP Registry

    Avinash Kambadakone-Ramesh, MD, DNB, FRCR, has had a financial relationship or affiliation with the following ineligible companies in the form of Consultant: Bayer. Grant/Research Support: Bayer, GE HealthCare, and PanCAN.

    The Evolve staff, planners, and peer reviewer have no financial relationships with ineligible companies.

  • Learning Objectives

    Upon completion of this activity, the participant should be able to

    • Identify the individual organ manifestations/clinical features that may support a diagnosis of IgG4-related disease
    • Outline the diseases and/or conditions whose manifestations have substantial overlap with IgG4-RD
  • Target Audience

    This certified continuing education activity is designed for rheumatologists, nurse practitioners, and physician assistants, as well as pathologists and radiologists who diagnose and treat patients involved in the diagnosis and management of IgG4-related disease.

  • Accreditation and Credit Designation Statements

    Provided by Evolve Medical Education 

    Evolve is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
    Evolve designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The American Medical Association has an agreement of mutual recognition of Continuing Medical Education (CME) credits with the European Union of Medical Specialists (UEMS), the accreditation body for European countries. Physicians interested in converting AMA PRA Category 1 Credit™ to UEMS-European Accreditation Council for Continuing Medical Education CME credits (ECMEC®s) should contact the UEMS at mutualrecognition@uems.eu.

  • Provider(s)/Educational Partner(s)

    Evolve Medical Education LLC (Evolve) is a leader in cultivating health care for patients by educating clinical competence of the health care team. Evolve achieves this by developing and distributing high-quality, evidence-based, valid, independent CME/CE activities in a variety of learning formats. These activities are designed to increase clinician’s knowledge, skills, competence and professional performance as well as to promote professional growth, maintenance of licensure, and support quality change in care of patients.

  • Commercial Support

    This activity is supported by an independent medical education grant from Amgen.

  • Disclaimer

    OFF-LABEL STATEMENT
    This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

    DISCLAIMER
    The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Evolve or Amgen.

    This activity is designed for educational purposes. Participants have a responsibility to utilize this information to enhance their professional development to improve patient outcomes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use. 

  • System Requirements

    • Supported Browsers (2 most recent versions):
      • Google Chrome for Windows, Mac OS, iOS, and Android
      • Apple Safari for Mac OS and iOS
      • Mozilla Firefox for Windows, Mac OS, iOS, and Android
      • Microsoft Edge for Windows
    • Recommended Internet Speed: 5Mbps+

  • Publication Dates

    Release Date:

    Expiration Date:

Schedule2 Dec 2024