The Royal College of Physicians is 500 years old this year, and has been the site for the discussion of many newly discovered diseases over that time. In March Dr George Webster, Consultant Gastroenterologist and Hepatologist at The Physicians' Clinic and UCL, with colleagues from Oxford University, organised the Inaugural UK IgG4-Related Disease Symposium (http://igg4-rd.ndm.ox.ac.uk/royal-college-of-physicians-london). More than 120 delegates and speakers attended from the UK, rest of Europe, and USA to learn, debate, and discuss this recently described disease. This disease may affect a wide range of organs, including the pancreas, liver, biliary tree, kidneys, lungs and salivary glands. Importantly it is a benign disease, but is often mistaken for cancer (e.g. pancreatic cancer), and as a result patients may undergo unnecessary surgery. The disease may respond well to treat with steroids or other immunosuppressants, although without timely treatment significant organ damage may occur. Reflecting the multiorgan nature of the disease the meeting was attended by a wide range of specialists, including gastroenterologists, radiologists, surgeons, pathologists, rheumatologists, and renal specialists. The meeting proved an excellent forum to discuss present scientific understanding as to the cause of IgG4-related disease, optimal investigation, best treatment, and how and where to refer patients for further assessment and management.