Corticosteroid-responsive pancreatic cyst found in autoimmune pancreatitis
Corticosteroid-responsive pancreatic cyst found in autoimmune pancreatitis
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DOI：
10.1007/s00535-005-1622-z
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发表时间：
2005-07-01
影响因子：
6.3
通讯作者：
Kiyosawa, K
中科院分区：
文献类型：
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作者：
Muraki, T;Hamano, H;Kiyosawa, K
目前仅有少数自身免疫性胰腺炎合并胰腺囊肿的报道，这种囊肿很少见，可能是因为在这种情况下没有严重的组织坏死和/或胰液淤积。然而，在对48名这种疾病患者的随访中，我们发现3名患者有胰腺囊肿，这使我们能够评估他们的临床病理结果。1994年9月至2003年7月，我们对48例自身免疫性胰腺炎患者进行了治疗和随访，发现3例胰腺囊肿形成，对激素治疗有反应。所有囊肿组均有较高的血清IgG4水平。经糖皮质激素治疗后，胰腺囊肿迅速消退。用山羊多克隆抗体对各免疫球蛋白亚类进行免疫染色，发现1例囊壁有大量IgG4阳性浆细胞浸润。血清中较高的IgG4浓度和对糖皮质激素治疗的良好反应表明，炎症过程的高度活跃状态与囊肿的形成密切相关，而对糖皮质激素敏感的胰腺囊肿是自身免疫性胰腺炎的特征。
There have been only a few reports of autoimmune pancreatitis complicated with pancreatic cyst and such cysts are rare, probably due to the absence of severe tissue necrosis and/or lack of stasis of the pancreatic juice in this condition. However, during a follow-up of 48 patients with this disease, we found 3 patients with pancreatic cysts, and this enabled us to evaluate their clinicopathological findings. Between September 1994 and July 2003, we treated and followed 48 patients with autoimmune pancreatitis, and found 3 patients with pancreatic cyst formation that was responsive to corticosteroid therapy. All of the patients with cysts had high serum IgG4 concentrations. After corticosteroid therapy, rapid resolution of the pancreatic cysts was observed. Immunostaining with goat polyclonal antibody for each IgG subclass showed severe infiltration of IgG4-positive plasma cells in the cyst wall in one patient. The high serum IgG4 concentration and favorable response to corticosteroid therapy suggests that a highly active state of the inflammatory process is closely associated with cyst formation, and that a corticosteroid-responsive pancreatic cyst is a characteristic feature of autoimmune pancreatitis.