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. 2024 Jul 19;11:1388940. doi: 10.3389/fmed.2024.1388940

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Copyright © 2024 Desmedt, Geldof, Hoorens and Lobaton.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Top left: Antral mucosa with chronic inactive gastritis and two non-necrotic granulomas (arrows). Middle left: Duodenal bulb mucosa with active chronic inflammation with erosion. Below left: IgG4 immunohistochemistry shows numerous IgG4-positive plasma cells in the duodenal mucosa (>100/HPF). There is background staining in the stroma, as is often seen with high serum IgG4 levels. Top right: Antral mucosa after treatment, without significant inflammation. Middle right: Duodenal mucosa after treatment, without significant inflammation. Below left: IgG4 immunohistochemistry shows rare residual IgG4-positive plasma cells in the duodenal mucosa. There is also much weaker background staining in the stroma compared to before treatment.