[A young woman with auto-immune pancreatitis]

Ned Tijdschr Geneeskd. 2023 Mar 16:167:D6683.
[Article in Dutch]

Abstract

Background: Acute pancreatitis is a frequently diagnosed disease. The majority is caused by cholelithiasis or alcohol. There are also two forms of auto-immune pancreatitis (AIP). Type 2 AIP presents on a younger age compared with IgG4 related pancreatitis. Clinical presentation as an acute pancreatitis, a mass in the pancreas or with jaundice. There is an association with inflammatory bowel disease.

Case description: A young patient with Crohn's disease developed abdominal pain compatible with acute pancreatitis. After exclusion of other etiologies a diagnosis of type 2 auto-immune pancreatitis was made with MRI/MRCP and typical histology. She was clinically successfully treated with steroids and follow up scan clearly showed improvement. Steroids were slowly withdrawn.

Conclusion: Also young patients and patients with a normal IgG4 can have an AIP. Diagnosis is based on clinical, radiological and histological criteria. Type 2 AIP is treated with steroids without the need for maintenance therapy.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Acute Disease
  • Autoimmune Diseases* / diagnosis
  • Autoimmune Pancreatitis* / diagnosis
  • Autoimmune Pancreatitis* / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunoglobulin G
  • Pancreas / pathology
  • Pancreatitis* / diagnosis
  • Pancreatitis* / drug therapy
  • Pancreatitis* / etiology
  • Steroids / therapeutic use

Substances

  • Immunoglobulin G
  • Steroids