Immunoglobulin G4 (IgG4)-related disease is a newly named fibroinflammatory condition characterized by tumefactive lesions that contain dense lymphoplasmacytic infiltrates rich in IgG4-positive cells. Elevated serum IgG4 concentrations also often accompany IgG4-related disease. Many medical conditions that were long viewed as diseases confined to single organs (e.g., Mikulicz disease, type 1 autoimmune pancreatitis, Riedel’s thyroiditis, multifocal fibrosclerosis, inflammatory pseudotumor, mediastinal fibrosis, retroperitoneal fibrosis, and etc.) are now designated as part of the spectrum of IgG4-related disease. The preferred nomenclature suggested by a committee of international experts uses the prefix “IgG4-related-” for individual organ involvement, regardless of the organ system affected. One exception is type 1 autoimmune pancreatitis (IgG4-related pancreatitis). Comprehensive diagnostic criteria for IgG4-related disease and organ-specific diagnostic criteria (e.g., IgG4- related dacryoadenitis and sialadenitis, type 1 autoimmune pancreatitis, IgG4-related kidney disease and IgG4-related sclerosing cholangitis) can aid clinicians in the diagnosis of this erratic condition.

자가면역췌장염과 췌장암의 감별진단은 유사한 임상증상 들과 영상검사소견을 보일 수 있기 때문에 종종 어렵다. 혈청 IgG4는 자가면역췌장염과 췌장암의 감별에 중요한 인자 이다. 췌장암 환자에서도 약 10%에서는 혈청 IgG4가 상승할 수 있으나, 대부분 정상 상한의 2배 이내이다. 그래서 저자들은 자가면역췌장염과 감별이 어려웠던 혈청 IgG4가 정상 상 한의 6배 이상으로 상승된 췌장암 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Electrical acupuncture has been shown to induce hypoglycemic effect in streptozotocin diabetic rats. The Zusanli acupoints have been widely used in traditional Chinese medicine to relieve symptoms of diabetes mellitus. But, the effects of electrical acupuncture stimulation of different frequencies are still unclear. We designed an experiment to investigate the effect of electrical acupuncture of high (100 Hz) and low (2 Hz) frequencies on Zusanli acupoint for 15 minutes in streptozotocin diabetic rats. They were divided into 4 groups, high frequency electrical acupuncture (HFEA group, n=5), low frequency electrical acupuncture (LFEA group, n=5), without any treatment (control group, n=5) and normal group (n=5). After 2 weeks of treatment, the HFEA and LFEA groups had a significantly decreased glucose concentration in serum in comparison to the control group. Additionally, the HFEA group had a significantly decreased glucose concentration in serum compared with the LFEA group. Both the HFEA and LFEA groups had a significantly decreased Immunoglobulin G concentration in serum compared with control group. The LFEA and control groups had a significantly increased cholesterol concentration in serum compared with the normal group, but the HFEA did not have a significantly increased cholesterol concentration. Thus we suggest that electrical acupuncture stimulation at the Zusanli acupoints is effective on hypoglycemic effect and immune function. Overall, the therapeutic effects of electrical acupuncture at 100 Hz was better than effects at 2 Hz.