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

Authors

  • Shuichiro Umemura Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Itaru Naitoh Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Takahiro Nakazawa Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Kazuki Hayashi Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Katsuyuki Miyabe Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Shuya Shimizu Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Hiromu Kondo Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Yuji Nishi Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Michihiro Yoshida Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Yasuki Hori Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Akihisa Kato Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Hirotaka Ohara Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Takashi Joh Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

DOI:

https://doi.org/10.6092/1590-8577/2393

Keywords:

Autoimmune Diseases, Cholangiopancreatography, Endoscopic Retrograde, Magnetic Resonance, Natural History, Neoplasms, Cystic, Mucinous, and Serous, Pancreatitis, Tomography, X-Ray Computed

Abstract

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.

Image: Remarkable change of main pancreatic duct.

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References

Okazaki K, Uchida K, Matsushita M, Takaoka M. Autoimmune pancreatitis. Intern Med 2005; 44:1215-1223. [PMID: 16415540].

The Japan Pancreatic Society and Research Committee of Intractable Diseases of the Pancreas. Clinical diagnostic criteria for autoimmune pancreatitis 2011. J Jpn Pancreas Soc 2012; 27:17-25.

Shimosegawa T, Chari ST, Frulloni L, Kamisawa T, Kawa S, Mino- Kenudson M, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas 2011; 40:352-358. [PMID: 21412117].

Naitoh I, Nakazawa T, Notohara K, Miyabe K, Hayashi K, Shimizu S, et al. Intraductal papillary mucinous neoplasm associated with autoimmune pancreatitis. Pancreas 2013; 42:552-554. [PMID: 23486370].

Tabata T, Kamisawa T, Hara S, Kuruma S, Chiba K, Kuwata G, et al. Intraductal papillary mucinous neoplasm of the pancreas and IgG4- related disease: a coincidental association. Pancreatology 2013; 13:379-

[PMID: 23890136].

Bateman AC, Culver EL, Sommerlad M, Chetty R. Intraduct papillary mucinous neoplasm of the pancreas: a tumour linked with IgG4-related disease? J Clin Pathol; 2013: 66:671-675. [PMID: 23596150].

Tanaka M, Fernández-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology 2102; 12:183-197. [PMID:

.

Manfredi R, Graziani R, Cicero C, Frulloni L, Carbognin G, Mantovani W, et al. Autoimmune pancreatitis: CT patterns and their changes after steroid treatment. Radiology 2008; 247:435-443. [PMID: 18430876].

Sahani DV, Sainani NI, Deshpande V, Shaikh MS, Frinkelberg DL, Fernandez-del Castillo C. Autoimmune pancreatitis: disease evolution, staging, response assessment, and CT features that predict response to corticosteroid therapy. Radiology 2009; 250:118-29. [PMID: 19017924].

Remarkable change of main pancreatic duct

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Published

2014-05-27

How to Cite

Umemura, S., Naitoh, I., Nakazawa, T., Hayashi, K., Miyabe, K., Shimizu, S., … Joh, T. (2014). 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. JOP. Journal of the Pancreas, 15(3), 261–265. https://doi.org/10.6092/1590-8577/2393

Issue

Vol. 15 No. 3 (2014): May - p. 219-279

Section

CASE REPORTS

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