High Serum IgG4 Concentrations in Patients with Sclerosing Pancreatitis

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Abstract
To the Editor: Hamano and colleagues (March 8 issue)1 described 20 patients with sclerosing pancreatitis and demonstrated that they had elevated serum IgG4 concentrations. Additional clinical information is needed. Did any of the patients have histologic evidence of the characteristic lymphoplasmacytic inflammation of sclerosing pancreatitis?2 Although this condition is characterized by infrequent attacks of abdominal pain, the symptoms and their duration were not described. How could the response to therapy be distinguished from spontaneous resolution? Can one evaluate a response to a brief course of corticosteroids in a disease that has a chronic course with infrequent attacks? What was the . . .