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Autoimmune pancreatitis complicated by an infected pseudocyst

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Abstract

A 53-year-old man was admitted due to upper abdominal pain. He had been diagnosed with autoimmune pancreatitis (AIP) 4 years previously and had been taking steroids for maintenance therapy since that time. Abdominal computed tomography revealed multiple pseudocysts in the head of the pancreas and a dilated pancreatic duct with mottled calcifications around the pseudocyst. Despite the continuation of steroid therapy for 4 months, the size of the pseudocyst increased further and diffuse calcifications developed throughout the pancreas. He was readmitted due to severe abdominal pain and a high fever, and endoscopic drainage of the pancreatic pseudocyst was performed. Two months after the internal drainage, the pseudocyst disappeared and his symptoms subsided. There are few reports concerning AIP complicated by the formation of pseudocysts. We report this case to emphasize that AIP can be complicated by the development of pseudocysts with progression to chronic pancreatitis, accompanied by multiple calcifications.

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References

  1. Ito T, Nakano I, Koyanagi S, et al. Autoimmune pancreatitis as a new clinical entity. Three cases of autoimmune pancreatitis with effective steroid therapy. Dig Dis Sci. 1997;42:1458–68.

    Article  CAS  PubMed  Google Scholar 

  2. Okazaki K, Uchida K, Chiba T. Recent concept of autoimmune related pancreatitis. J Gastroenterol. 2001;36:293–302.

    Article  CAS  PubMed  Google Scholar 

  3. Yoshida K, Toki F, Takeuchi T, Watanabe S, Shiratori K, Hayashi N. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis. Dig Dis Sci. 1995;40:1561–8.

    Article  CAS  PubMed  Google Scholar 

  4. Okazaki K, Chiba T. Autoimmune related pancreatitis. Gut. 2002;51:1–4.

    Article  CAS  PubMed  Google Scholar 

  5. Kitoh H, Kondoh S, Naoki U, et al. Focal autoimmune pancreatitis which discovered for formation of a large pancreatic pseudocyst. Nippon Naika Gakkai Zasshi. 2003;92:871–3.

    PubMed  Google Scholar 

  6. Okamoto T, Niwakawa M, Yasuoka T, Kajinami T, Fujiyama Y, Bamba T. Autoimmune pancreatitis complicated with pseudocyst. A case report. J Jpn Pancreas Soc. 2003;18:228–34.

    Google Scholar 

  7. Nakazawa T, Ohara H, Sano H, et al. Cholangiography can discriminate sclerosing cholangitis with autoimmune pancreatits from primary sclerosing cholangitis. Gastrointest Endosc. 2004;60:937–44.

    Article  PubMed  Google Scholar 

  8. Nishimura T, Masaoka T, Suzuki H, Aiura K, Nagata H, Ishii H. Autoimmune pancreatitis with pseudocysts. J Gastroenterol. 2004;39:1005–10.

    Article  PubMed  Google Scholar 

  9. Kamisawa T. IgG4-positive plasma cells specifically infiltrate various organs in autoimmune pancreatitis. Pancreas. 2004;29:167–8.

    Article  PubMed  Google Scholar 

  10. Kim KP, Kim MH, Song MH, Lee SS, Seo DW, Lee SK. Autoimmune chronic pancreatitis. Am J Gastroenterol. 2004;99:1605–16.

    Article  PubMed  Google Scholar 

  11. Muraki T, Hamano H, Ochi Y, et al. Corticosteroid-responsive pancreatic cyst found in autoimmune pancreatitis. J Gastroenterol. 2005;40:761–6.

    Article  PubMed  Google Scholar 

  12. Welsch T, Kleeff J, Esposito I, Buchler MW, Friess H. Autoimmune pancreatitis associated with a large pancreatic pseudocyst. World J Gastroenterol. 2006;12:5904–6.

    PubMed  Google Scholar 

  13. Falck VG, Dixon E. Pseudocysts may be seen in immunoglobulin G4-associated autoimmune pancreatitis. Arch Pathol Lab Med. (2007);131:16.

    Google Scholar 

  14. Nakazawa T, Ohara H, Sano H, et al. Difficulty in diagnosing autoimmune pancreatitis by imaging findings. Gastrointest Endosc. 2007;56:1719–24.

    Google Scholar 

  15. Hirano K, Tada M, Isayama H, et al. Long-term prognosis of autoimmune pancreatitis with and without corticosteroid treatment. Gut. 2007;56:1719–24.

    Article  CAS  PubMed  Google Scholar 

  16. Kawakami H, Kuwatani M, Shinada K, et al. Autoimmune pancreatits associated with hemorrhagic pseudocysts: a case report and literature review. Intern Med. 2008;47:603–8.

    Article  PubMed  Google Scholar 

  17. Kamisawa T, Funata N, Hayashi Y, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol. 2003;38:982–4.

    Article  CAS  PubMed  Google Scholar 

  18. Horiuchi A, Kawa S, Akamatsu T, et al. Characteristic pancreatic duct appearance in autoimmune chronic pancreatitis: a case report and review of the Japanese literature. Am J Gastroenterol. 1998;93:260–3.

    Article  CAS  PubMed  Google Scholar 

  19. Nishmura N, Tamada K, Wada S, et al. Autoimmune pancreatitis associated with a large pancreatic pseudocyst that disappeared after corticosteroid therapy: a case report and literature review. Clin J Gastroenterol. 2009;2:199–203.

    Article  Google Scholar 

  20. Takayama M, Hamano H, Ochi Y, et al. Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation. Am J Gastroenterol. 2004;99:932–7.

    Article  PubMed  Google Scholar 

  21. Nealon WH, Walser E. Main pancreatic ductal anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage). Ann Surg. 2002;235:751–8.

    Article  PubMed  Google Scholar 

  22. Ito T, Nishimori I, Inoue N, et al. Treatment for autoimmune pancreatitis: consensus on the treatment for patients with autoimmune pancreatitis in Japan. J Gastroenterol. 2007;42:50–8.

    Article  PubMed  Google Scholar 

  23. Kamisawa T, Okamoto A, Wakabayashi T, Watanabe H, Sawabu N. Appropriate steroid therapy for autoimmune pancreatitis based on long-term outcome. Scand J Gastroenterol. 2008;43:609–13.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Tae Nyeun Kim.

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Chang, K.A., Kim, T.N. & Lee, S.H. Autoimmune pancreatitis complicated by an infected pseudocyst. Clin J Gastroenterol 3, 168–173 (2010). https://doi.org/10.1007/s12328-010-0152-2

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  • DOI: https://doi.org/10.1007/s12328-010-0152-2

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