Petr Dítě, Ivo Novotný, Bohumil Kianička, Jan Trna
IgG4 is a new clinical pathological entity which is characterised by high plasmatic level of IgG4 and massive infiltration of the tissue by globulin G4. Besides this a typical finding is the tissue infiltration of T-lymphocytes by obliterative phlebitides. The salivary and lacrimal glands, lungs, kidneys, prostate, retroperitoneal connective tissue and biliary system can be affected. The most frequent is autoimmune pancreatitis. Diagnostics, besides above mentioned markers, is in particular histopathological. In the case of the autoimmune form of pancreatitis and IgG4 sclerosing cholangitis the use of imaging methods is indicated, including ERCP! Corticoids are on the first place in the treatment of this group of diseases; their effect can be expected in approximately 90 % of treated patients. The diagnostics of these diseases as well as differential diagnostics of malignity are completely fundamental and in their consequences they prevent e.g. non-indicated and dispensable surgical treatment.