Reviewer ’s report  
 
Title: Multivisceral IgG4 -related disease presenting as recurrent massive gastrointestinal 
bleeding: a case report and literature review  
 
Version: 2 Date: 30 Jun 2018  
 
Reviewer: Hsu-Heng Yen  
 
Reviewer's report:  
 
Dear Editor  
 
  This is an interesting case of IgG4 related disease with GI ble eding. The followings are my 
comments.  
 
Major.  
 #1. Page 4. The authors mention active bleeding from duodenal ulcer and mild esophageal varix. 
Why TIPS was performed in this case ?  
 #2. Page 4. The patient received at least two gastroscopy and duodenal u lcer was noted. Is there 
interval change in the morphology of duodenal  ulcers during these two procedures ? Why the 
authors perform biopsy from duodenal ulcer ? Readers may learn from the authors the                    
timing and ration ale of duodenal biopsy.  
 #3. Page 4.  How to explain recurrent from a clean based duodenal ulcer in this case ? Is there 
any possibility of ectopic variceal bleeding from cholecystojejunostomy ?  
 $4. Page 4.   " Three cavity two caps ules were placed to hemostasis by compression and tube 
feeding hemostatic medicine ". What "cavity" and what "capsule" the authors used ?. What kind 
of "hemostatic" medicine used ?  
 
Minor.  
 #1. Do the authors perform endoscopic follo w-up of the duodenal ulcer ?  
Best 
Hsu-Heng Yen, MD  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some lang uage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of t his manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applie d for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that  I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Multivisceral IgG4 -related disease presenting as recurrent massive gastrointestinal 
bleeding: a case report and literature review  
 
Version: 2 Date: 30 Jun 2018  
 
Reviewer: Hsu-Heng Yen  
 
Reviewer's report:  
 
Dear Editor  
 
  This is an interesting case of IgG4 related disease with GI ble eding. The followings are my 
comments.  
 
Major.  
 #1. Page 4. The authors mention active bleeding from duodenal ulcer and mild esophageal varix. 
Why TIPS was performed in this case ?  
 #2. Page 4. The patient received at least two gastroscopy and duodenal u lcer was noted. Is there 
interval change in the morphology of duodenal  ulcers during these two procedures ? Why the 
authors perform biopsy from duodenal ulcer ? Readers may learn from the authors the                    
timing and ration ale of duodenal biopsy.  
 #3. Page 4.  How to explain recurrent from a clean based duodenal ulcer in this case ? Is there 
any possibility of ectopic variceal bleeding from cholecystojejunostomy ?  
 $4. Page 4.   " Three cavity two caps ules were placed to hemostasis by compression and tube 
feeding hemostatic medicine ". What "cavity" and what "capsule" the authors used ?. What kind 
of "hemostatic" medicine used ?  
 
Minor.  
 #1. Do the authors perform endoscopic follo w-up of the duodenal ulcer ?  
Best 
Hsu-Heng Yen, MD  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some lang uage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of t his manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applie d for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that  I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Multivisceral IgG4 -related disease presenting as recurrent massive gastrointestinal 
bleeding: a case report and literature review  
 
Version: 2 Date: 30 Jun 2018  
 
Reviewer: Hsu-Heng Yen  
 
Reviewer's report:  
 
Dear Editor  
 
  This is an interesting case of IgG4 related disease with GI ble eding. The followings are my 
comments.  
 
Major.  
 #1. Page 4. The authors mention active bleeding from duodenal ulcer and mild esophageal varix. 
Why TIPS was performed in this case ?  
 #2. Page 4. The patient received at least two gastroscopy and duodenal u lcer was noted. Is there 
interval change in the morphology of duodenal  ulcers during these two procedures ? Why the 
authors perform biopsy from duodenal ulcer ? Readers may learn from the authors the                    
timing and ration ale of duodenal biopsy.  
 #3. Page 4.  How to explain recurrent from a clean based duodenal ulcer in this case ? Is there 
any possibility of ectopic variceal bleeding from cholecystojejunostomy ?  
 $4. Page 4.   " Three cavity two caps ules were placed to hemostasis by compression and tube 
feeding hemostatic medicine ". What "cavity" and what "capsule" the authors used ?. What kind 
of "hemostatic" medicine used ?  
 
Minor.  
 #1. Do the authors perform endoscopic follo w-up of the duodenal ulcer ?  
Best 
Hsu-Heng Yen, MD  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some lang uage corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of t his manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applie d for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that  I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Acc ess Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant