An Unexpected IgG4-Related Enteropathy Masquerading as a Stricturing Malignancy

Abstract

IgG related enteropathy is a rare entity with a characteristic histologic picture and elevated IgG plasma cells that may mimic malignancy on clinical presentation This report describes a year old female that developed abdominal pain nausea and vomiting refractory to medical management A CT scan showed a centimeter segment of thickened and strictured right colon Biopsies of the mucosa showed ulceration granulation tissue and mucosal injury Due to concern for malignancy a right hemicolectomy was performed with the final pathology displaying multifocal lymphoplasmacytic infiltrates and IgG positive plasma cells within fibrotic regions of the submucosa This case highlights the unique and challenging presentation of IgG enteropathy with an emphasis on early detection and preventing unnecessary surgical morbidity as this disease process is highly responsive to steroids