Title: A case of autoimmune pancreatitis with progressive change from segmental swelling of the pancreatic tail
Abstract: Mizuka Suzuki, Terumi Kamisawa, Yuyang Tu, and Naoto Egawa. Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan SUIZOU 2003;18(1):48–54. A 68-year-old man was admitted to a local hospital for cholangitis. The patient was a known diabetic. Abdominal CT scan showed swelling of the pancreatic tail. Laparoscopic cholecystectomy was performed, and histological examination of the resected specimen showed chronic cholecystitis with no gallstones. Biopsy of the pancreas showed inflammatory cell infiltration. Six month later, the swelling of the pancreas disappeared without any specific treatment. In April 2001, the patient was admitted to our hospital for worsening of diabetes. Abdominal ultrasonography and CT scan showed swelling of the entire pancreas. Endoscopic retrograde cholangiopancreatography showed diffuse narrowing of the main pancreatic duct. Laboratory tests showed hyperglobulinemia and high IgG 4 levels. Anti-carbonic anhydrase II antibody was positive. The final diagnosis was recurrent autoimmune pancreatitis. He was treated with corticosteroids, which resulted in reduction of pancreatic swelling and improvement of abnormal blood tests during the first two weeks.