Autoimmune Pancreatitis Presenting a Short Narrowing of Main Pancreatic Duct with Subsequent Progression to Diffuse Pancreatic Enlargement over 24 Months; Natural History of Autoimmune Pancreatitis
Autoimmune Pancreatitis Presenting a Short Narrowing of Main Pancreatic Duct with Subsequent Progression to Diffuse Pancreatic Enlargement over 24 Months; Natural History of Autoimmune Pancreatitis
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DOI：
10.6092/1590-8577/2393
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发表时间：
2014-05-01
影响因子：
0.2
通讯作者：
Joh, Takashi
中科院分区：
文献类型：
--
作者：
Umemura, Shuichiro;Naitoh, Itaru;Joh, Takashi
背景自身免疫性胰腺炎（AIP）的初始胰腺造影和自然病史尚未明确，最近关于AIP和导管内乳头状粘液性肿瘤（IPMN）之间关系的研究很少。病例报告我们报告一位81岁男性AIP合并IPMN。虽然最初的胰腺造影是正常的，但在6个月后的IPMN随访期间，主胰管（MPD）出现了短暂的狭窄，这高度提示胰腺癌。15个月后，MPD狭窄扩大，24个月后进展为MPD弥漫性狭窄，血清IgG 4水平升高。最后，根据2011年日本诊断标准和国际共识诊断标准，患者被诊断为弥漫型AIP。考虑到AIP的自然病程，MPD的这种显著变化表明了这种情况。结论：我们报告一例AIP，在IPMN随访期间表现为MPD短暂狭窄，随后进展为弥漫性胰腺肿大。
Context Initial pancreatogram and natural history of autoimmune pancreatitis (AIP) have not been clarified, and there were few recent studies concerning the association between AIP and intraductal papillary mucinous neoplasm (IPMN). Case report We report an 81-year-old man with AIP associated with IPMN. Although the initial pancreatogram was normal, a short narrowing of the main pancreatic duct (MPD) appeared during a follow-up for IPMN after 6 months, which was highly suggestive of pancreatic cancer. A narrowing of the MPD extended after 15 months, and this progressed to diffuse narrowing of the MPD with an elevation in the serum IgG4 levels after 24 months. Finally, the patient was diagnosed with diffuse-type AIP, according to the Japanese diagnostic criteria 2011 and the International Consensus Diagnostic Criteria. Considering the natural history of AIP, this marked change of the MPD is indicative of this condition. Conclusion We report a case of AIP presenting with a short narrowing of the MPD with subsequent progression to diffuse pancreatic enlargement during a follow-up for IPMN.