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Pitfalls of diagnosing autoimmune pancreatitis


Authors: Denisa Frajerová
Authors place of work: II. interní oddělení – Gastroenterologie, Krajská zdravotní, a. s., Nemocnice Teplice, o. z.
Published in the journal: Vnitř Lék 2021; 67(E-7): 24-27
Category: Case reports

Summary

The diagnosis of the rare disease autoimmune pancreatitis (AIP) is demonstrated in the case of a patient who underwent a series of examinations that were unable to unequivocally prove the diagnosis of benignity. The disease as a form of chronic pancreatitis, and the most important and first objective of the examination is to exclude malignant disease of the pancreas and biliary tract. While imaging led to suspicion of malignancy, repeated histological examinations did not confirm it. After we were able to exclude suspected carcinoma according to the available diagnostic criteria, AIP was confirmed, and a diagnosis of type I was made, which belongs to the group of diseases characterized by high levels of immunoglobulin G4 (IgG4) in the blood serum. Successful treatment with glucocorticoids was initiated with induction of disease remission. However, AIP shows frequent relapses and this should also be borne in mind during treatment. Our case report also describes such a case.

Keywords:

Pancreatic cancer – autoimmune pancreatitis – IgG4 – obstructive icterus – choledochal stenosis


Zdroje

1. Blaho M, Dítě P, Kunovský L, Kianička B. Autoimmune pancreatitis – An ongoing challenge. Adv Med Sci 2020; 65(2): 403–408.

2. Mačinga P, Jarošová j, Špičák J a Hucl T. Imonoglobulin G4 asociované onemocnění v gastroenterologii. Vnitř Lék 2021; 67(2): 76–83.

3. Dítě P. Novotný I, Kianička B et al. Autoimunitní pankreatitida – diagnostický konsenzus. Vnitř Lék 2015; 61(2): 114–118.

4. Kunovský L, Dítě P, Blaho M, Dvořáčková J et al. Is autoimmune pancreatitis a risk factor for pancreatic adenocarcinoma? Vnitř Lék 2021; 67(1): e9–e13.

5. Masamune A, Kikuta K, Hamada S et al. Nationwide epidemiological survey of autoimmune pancreatitis in Japan in 2016. J Gastroenterol. 2020; 55(4): 462–470.

6. Dítě P, Ševčíková A et al. Automunitní pankreatitida v České republice – region jižní Morava. Čes a Slov Gastroent a Hepatol 2007; 61(2): 82–85.

7. Sarles H, Sarles J‑ C et al. Chronic inflammatory sclerosis of the pancreas: an autonomous pancreatic disease? Am J Dig Dis 1961 Jul; 6: 688–698.

8. Yoshida K, Toki F, Takeuchi T et al. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 1995; 40(7): 1561–1568.

9. Kamisawa T, Okazaki K, Kawa S. Diagnostic criteria for autoimmune pancreatitis in Japan. World J Gastroenterol 2008; 14(32): 4992–4994.

10. Kamisawa T, Funata N, Hayashi Y et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol 2003; 38(10): 982–984.

11. Novotný I, Dítě P, Lata J et al. Autoimmune pancreatitis – recent advances Dig Dis (Basel) 2010; 28(2): 334–338.

12. Feldman M et al. Sleisenger and Fortran’s Gastrointestinal and Liver Disease. Vol. 1. 10th Edition, 2016: 1001.

13. Kupka T, Novotný I, Kunovský L et al. Idiopatický střevní zánět a 1. typ autoimunitní formy pankreatitidy: kazuistika. Vnitř Lék 2019; 65(7–8): 520–523.

14. Kunovský L, Dítě P, Bojková M et al. Diagnostika a terapie chronické pankreatitidy dle UEG guidelines. Vnitř Lék 2021; 67(2): 85–91.

15. Löhr J‑M, Beuers U, Vujasinovic M et al. European Guideline on IgG4-related digestive disease – UEG and SGF evidence‑based recommendations. United European Gastroenterology Journal 2020; 8(6): 637–666.

Štítky
Diabetology Endocrinology Internal medicine
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