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Autoimmune Pancreatitis: A Case of Atypical Radiographic Findings

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ABSTRACT

Autoimmune pancreatitis (AIP) is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD). AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids.

No MeSH data available.


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CT showing mild dilatation of the common bile duct (arrow).
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Figure 1: CT showing mild dilatation of the common bile duct (arrow).

Mentions: Laboratory workup on admission revealed elevation in Total bilirubin 3.4 mg/dl, alanine transaminase (ALT) 227 U/l, aspartate transaminase (AST) 207 U/l, alkaline phosphatase (ALK P) 203 U/l, lipase 1148 U/l, and a white blood cell count of 6.7 K/μl. Urine analysis was positive for bilirubin. Hepatitis B and C were negative. A CT of the abdomen and pelvis with contrast revealed a distended gallbladder with questionable gallstones along with mild dilatation of the common bile duct with no mass or peripancreatic inflammation (fig 1). An MRI of her abdomen revealed a mildly distended gallbladder, mild gallbladder all thickening, sludge, and small gallstones. She was treated at that time for presumed gallstone pancreatitis.


Autoimmune Pancreatitis: A Case of Atypical Radiographic Findings
CT showing mild dilatation of the common bile duct (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121540&req=5

Figure 1: CT showing mild dilatation of the common bile duct (arrow).
Mentions: Laboratory workup on admission revealed elevation in Total bilirubin 3.4 mg/dl, alanine transaminase (ALT) 227 U/l, aspartate transaminase (AST) 207 U/l, alkaline phosphatase (ALK P) 203 U/l, lipase 1148 U/l, and a white blood cell count of 6.7 K/μl. Urine analysis was positive for bilirubin. Hepatitis B and C were negative. A CT of the abdomen and pelvis with contrast revealed a distended gallbladder with questionable gallstones along with mild dilatation of the common bile duct with no mass or peripancreatic inflammation (fig 1). An MRI of her abdomen revealed a mildly distended gallbladder, mild gallbladder all thickening, sludge, and small gallstones. She was treated at that time for presumed gallstone pancreatitis.

View Article: PubMed Central - PubMed

ABSTRACT

Autoimmune pancreatitis (AIP) is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD). AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids.

No MeSH data available.


Related in: MedlinePlus