# Young Symptomatic Female Patient With IgG4-Related Benign Biliary Stricture: A Case Report

## TL;DR

A young woman with a rare bile duct condition and high IgG4 levels is reported, showing the varied ways this disease can present.

## Contribution

This case adds to understanding the diverse clinical features of IgG4-related diseases in young patients.

## Key findings

- The patient had a bile duct stricture with elevated IgG4 but no systemic disease features.
- She required ERCP and corticosteroids for symptom management.
- This case highlights the heterogeneity of IgG4-related disease presentations.

## Abstract

Biliary strictures occur due to the narrowing of the bile ducts, leading to impaired normal flow of bile. This leads to a spectrum of symptoms ranging from being asymptomatic to displaying symptoms secondary to obstruction. Hence, we present a case of a young female patient presenting to the Emergency Department with recurrent abdominal pain requiring intravenous analgesia; imaging shows stricture of the common bile duct with no pathological lesions but elevated plasma IgG4 levels. Our case is particularly unique because the patient displays no systemic features of IgG4-related disease yet requires serial endoscopic retrograde cholangiopancreatography (ERCP) and oral corticosteroids. Given the peculiarity of such presentation in a young female patient, this case contributes to the ongoing research on the heterogeneity of IgG4-related diseases.