A case of type 2 autoimmune pancreatitis with spontaneous remission
A case of type 2 autoimmune pancreatitis with spontaneous remission
复制标题
2型自身免疫性胰腺炎自发缓解1例
DOI：
10.1007/s12328-022-01753-y
复制
发表时间：
2023
影响因子：
1
通讯作者：
Naganuma Makoto
中科院分区：
文献类型：
--
作者：
Ito Takashi;Ikeura Tsukasa;Notohara Kenji;Masuda Masataka;Nakamaru Koh;Nakayama Shinji;Shimatani Masaaki;Takaoka Makoto;Okazaki Kazuichi;Naganuma Makoto
一位70岁男性因上腹部疼痛转介至本院。计算机断层扫描和磁共振成像显示，与6个月前的正常胰腺相比，胰腺弥漫性增大。血清IgG 4和淀粉酶水平正常，而C反应蛋白略有升高。内镜超声引导下胰腺细针活检显示腺泡导管化生伴中性粒细胞浸润，无IgG 4阳性浆细胞浸润。在临床诊断为2型自身免疫性胰腺炎（AIP）后，他的症状自发改善，无需类固醇治疗。三个月后，放射学检查结果显示胰腺大小和血清学检查结果改善。2型AIP的病理诊断使用内镜超声引导细针活检是具有挑战性的，特别是在证明粒细胞上皮病变。这是一个有价值的2型AIP病例，对发病前、发病时和自发缓解时的图像进行了评价。
A 70-year-old man with epigastric pain was referred to our hospital. Computed tomography and magnetic resonance imaging showed the diffusely enlarged pancreas compared to his normal pancreas 6 months prior to presentation. Serum levels of IgG4 and amylase were normal, while C-reactive protein was slightly elevated. Endoscopic ultrasound-guided fine-needle biopsy of the pancreas revealed acinar–ductal metaplasia with neutrophil infiltration and without infiltration of IgG4-positive plasma cells. After the clinical diagnosis of type 2 autoimmune pancreatitis (AIP), his symptoms spontaneously improved without steroid therapy. Three months later, radiological findings showed improved pancreas size and serological findings. The pathological diagnosis of type 2 AIP using endoscopic ultrasound-guided fine-needle biopsy is challenging, particularly for proving granulocyte epithelial lesions. This was a valuable type 2 AIP case in which the images before, at the time of onset, and at the time of spontaneous remission were evaluated.