Duct‐obstructive pancreatitis with granulocytic epithelial lesion in a patient with ulcerative colitis: An atypical manifestation of type 2 autoimmune pancreatitis?

2019 ◽  
Vol 69 (7) ◽  
pp. 420-426
Author(s):  
Soomin Ahn ◽  
Jong‐chan Lee ◽  
Jin‐Hyeok Hwang ◽  
Yoo‐Seok Yoon ◽  
Kyoung Ho Lee ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Autoimmune Pancreatitis ◽  
Obstructive Pancreatitis ◽  
Epithelial Lesion ◽  
Granulocytic Epithelial Lesion ◽  
Atypical Manifestation

scholarly journals Type 2 Autoimmune Pancreatitis with Ulcerative Colitis Manifesting as Acute Pancreatitis

2018 ◽  
Vol 93 (2) ◽  
pp. 206-210
Author(s):  
Ha Il Kim ◽  
Hye Min Chung ◽  
Jung Hwan Lee ◽  
Soo Min Noh ◽  
Li Chang Hsing ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Acute Pancreatitis ◽  
Autoimmune Pancreatitis

scholarly journals Case Report: Development of Type 1 Autoimmune Pancreatitis in an Adolescent With Ulcerative Colitis Mimicking Pancreatic Cancer

2021 ◽  
Vol 9 ◽  
Author(s):  
Sujin Choi ◽  
Hae Jeong Lee ◽  
An Na Seo ◽  
Han Ik Bae ◽  
Hyung Jun Kwon ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Autoimmune Pancreatitis ◽  
Pancreatic Enzyme ◽  
Pancreatic Neoplasm ◽  
Gastrointestinal Symptoms ◽  
Corticosteroid Treatment ◽  
Pancreatic Enzymes ◽  
Extraintestinal Manifestation ◽  
Abdominal Ultrasonography

Introduction: Autoimmune pancreatitis (AIP) is a rare extraintestinal manifestation of inflammatory bowel disease (IBD) which is typically responsive to corticosteroid treatment.Case Presentation: We report a case of a 17-year-old male diagnosed with ulcerative colitis who subsequently developed acute pancreatitis. Blood tests demonstrated elevated pancreatic enzyme levels of amylase (1319 U/L) and lipase (809 U/L). Abdominal computed tomography revealed peripancreatic fat stranding and the presence of a perisplenic pseudocyst. Azathioprine and mesalazine were stopped as possible causes of drug-induced pancreatitis. However, pancreatic enzymes remained elevated and corticosteroid treatment was started. Despite corticosteroid therapy, amylase and lipase levels continued to increase. Infliximab was started due to a flare in gastrointestinal symptoms of ulcerative colitis. Follow-up abdominal ultrasonography revealed a pancreatic tail mass. Tumor markers, including CA 19-9, were elevated and atypical cells were seen on histological examination of an endoscopic ultrasonography-guided fine needle aspiration biopsy. Surgical pancreaticosplenectomy was performed for suspected pancreatic neoplasm. Surprisingly, histology revealed chronic pancreatitis with storiform fibrosis and infiltration of IgG4-positive cells, compatible with AIP type 1. Thereafter, pancreatic enzymes gradually decreased to normal levels and the patient has been in remission for 9 months on infliximab monotherapy.Conclusion: Pediatric gastroenterologists should keep in mind that AIP may develop during the natural course of pediatric IBD. Moreover, the development of pancreatic fibrosis may be non-responsive to corticosteroid treatment and mimic pancreatic neoplasia.

Recent advances in autoimmune pancreatitis: type 1 and type 2

Gut ◽  
2013 ◽  
Vol 62 (9) ◽  
pp. 1373-1380 ◽  
Author(s):  
Terumi Kamisawa ◽  
Suresh T Chari ◽  
Markus M Lerch ◽  
Myung-Hwan Kim ◽  
Thomas M Gress ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Recent Advances

Autoimmune Pancreatitis

2018 ◽  
Author(s):  
Allison L Yang ◽  
Julia McNabb-Baltar
Keyword(s):  
Chronic Pancreatitis ◽  
Obstructive Jaundice ◽  
Autoimmune Pancreatitis ◽  
Pancreatic Insufficiency ◽  
Imaging Findings ◽  
Laboratory Findings ◽  
Related Disease

Autoimmune pancreatitis (AIP) is a subcategory of chronic pancreatitis that is highly responsive to steroids. The term was first proposed in 1995 by Yoshida and colleagues, and since its discovery, the diagnosis of AIP has dramatically increased. AIP is a chronic fibroinflammatory disease characterized by lymphoplasmacytic infiltrates and fibrosis on histology. There are two distinct subtypes: type 1 AIP is the pancreatic manifestation of a systemic serum immunoglobulin G subtype 4–related disease (IgG4-RD) and type 2 AIP is described clinically as idiopathic duct-centric pancreatitis and has no association with IgG4. Clinically, AIP presents most commonly as obstructive jaundice in type 1 AIP and can present as acute pancreatitis in type 2 AIP. The diagnostic criteria include histology, imaging findings, and responsiveness to steroids as well as laboratory findings and other organ involvement. The mainstay of treatment is steroid therapy, with immunomodulators such as rituximab used for maintenance or relapsing disease. Long-term complications of AIP include pancreatic insufficiency and are often associated with relapsing disease. This review contains 45 references, 1 figure, and 2 tables. Key Words: autoimmune pancreatitis, chronic pancreatitis, EUS-guided biopsy, IgG4, immunomodulatory, obstructive jaundice, pancreas mass, steroid

Surgery in autoimmune pancreatitis

2021 ◽  
Author(s):  
Sara Nikolic ◽  
Poya Ghorbani ◽  
Raffaella Pozzi Mucelli ◽  
Sam Ghazi ◽  
Francisco Baldaque- Silva ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
University Hospital ◽  
Premalignant Lesions ◽  
Single Centre ◽  
Age At Surgery ◽  
Diagnostic Work ◽  
Work Up

Introduction: Autoimmune pancreatitis (AIP) is a disease that may mimic malignant pancreatic lesions both in terms of symptomatology and imaging appearance. The aim of the present study is to analyse experiences of surgery in patients with AIP in one of the largest European cohorts. Methods: We performed a single-centre retrospective study of patients diagnosed with AIP at the Department of Abdominal Diseases at Karolinska University Hospital in Stockholm, Sweden, between January 2001 and October 2020. Results: There were 159 patients diagnosed with AIP, and among them 35 (22.0%) patients had surgery: 20 (57.1%) males and 15 (42.9%) females; average age at surgery was 59 years (range 37-81). Follow-up period after surgery was 67 months (range 1-235). AIP type 1 was diagnosed in 28 (80%) patients and AIP type 2 in 7 (20%) patients. Malignant and premalignant lesions were diagnosed in 8 (22.9%) patients for whom AIP was not the primary differential diagnosis but, in all cases, it was described as a simultaneous finding and recorded in retrospective analysis in histological reports of surgical specimens. Conclusions: Diagnosis of AIP is not always straightforward, and, in some cases, it is not easy to differentiate it from the malignancy. Surgery is generally not indicated for AIP but might be considered in patients when suspicion of malignant/premalignant lesions cannot be excluded after complete diagnostic work-up.

Autoimmune Pancreatitis Type 2

2019 ◽  
Vol 43 (7) ◽  
pp. 898-906 ◽  
Author(s):  
Rajib Gupta ◽  
Azfar Neyaz ◽  
Abhijit Chougule ◽  
Masayuki Akita ◽  
Yoh Zen ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis

IL-8 Expression in Granulocytic Epithelial Lesions of Idiopathic Duct-centric Pancreatitis (Type 2 Autoimmune Pancreatitis)

2017 ◽  
Vol 41 (8) ◽  
pp. 1129-1138 ◽  
Author(s):  
Yuna Ku ◽  
Seung-Mo Hong ◽  
Kohei Fujikura ◽  
Sung Joo Kim ◽  
Masayuki Akita ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Epithelial Lesions
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