Brief Answer:
no need to worry.

Detailed Answer:
Hello dear, thanks for your question on HCM.
I want to ask you some questions first.
1. Are you smoker?
2. What symptoms are you having at present?
IgG s are protective antibodies and whenever detect , suggest past infection.
In certain conditions, they tend to rise in many folds (10-20 times).
In my opinion your Ig G4 level is not that much high. It is only slightly high. This can be most probably due to past infection. Infection can be anywhere in the past.
So no need to worry for this much rise in Ig G4 level.
So I don't think this result is having any significance in your case. So relax about it.
Conditions associated with raised IgG4 are
1. Past infection and smokers (mild rise)
2. Acute pancreatitis (many fold rise)
3. Chronic pancreatitis (many fold rise)
4. Pancreatic mass (many fold rise)
5. Sjogren's syndrome (many fold rise)
6. Atopic dermatitis (many fold rise along with rise in Ig E).
Etc.
So causes are many but I don't think any of the above except past infection is significant in your case.
So no need to worry about this much rise in IgG 4.
If you are asymptomatic than no need for any further investigation s.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

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Brief Answer:
you need further investigations for diagnosis.

Detailed Answer:
Thanks for your query.
Auto immune pancreatitis(AIP) is a subtype of chronic pancreatitis.
And on clinical ground it is quite difficult to differentiate between AIP and early pancreatic malignancy. As symptoms of both are almost similar.
For AIP diagnosis following criteria are available.
Criteria 1- CT shows diffuse narrowing of main pancreatic duct with irregular wall.
Criteria 2- Blood investigations like high Ig G4 level and presence of autoantibodies.
Criteria 3- histopathology of pancreas showing fibrosis with lymphocytes and plasma cell infiltrate.
For diagnosis criteria 1 must be present. Any of the criteria 2/3 has to present also.
Another important clinical aspect of diagnosis is tremendous response with steroids.
AIP shows dramatic response with prednisolone.
So to summerize AIP can be the cause if criterias are matched.
Hope I have solved your query. If you are not having further queries please close the conversation and rate the answer. Thanks.

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Brief Answer:
newer markers are under pipeline at present.

Detailed Answer:
Hello dear, thanks for your query again.
EUS is good tool to detect early pancreatic tumours.
But in my opinion CT scan and MRI can give better imaging of pancrease. So discuss with your doctor and get it done.
Newer tumour markers for early pancreatic malignancy are in the pipeline. I am not sure whether they are commercial done or not.
Newer markers are
1. Based on gene expression.
2. DNA methylation.
3. Based on proteomics alterations.
So better to discuss all these with your GI doctor whom you are going to consult.
Hope I have solved your query. Do let me know once you done your second opinion. If you feel that I have solved your queries satisfactory, please close the conversation and rate the answer.

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