Mishima Shiho, Mizuta Yohei, Yamao Takuji, Yamakawa Masaki, Akazawa Yuko, Mishima Ryosuke, Ohba Kazuo, Masuda Jun-ich, Ohnita Ken, Isomoto Hajime, Shikuwa Saburo, Omagari Katsuhisa, Kohno Shigeru
Department of Internal Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan.
Intern Med. 2007;46(7):377-81. doi: 10.2169/internalmedicine.46.6184. Epub 2007 Apr 2.
An 80-year-old woman was admitted to our hospital with complaints of jaundice and liver dysfunction. She was found to have a high titer of serum IgG4, positive rheumatoid factor and marked elevation of DUPAN-2 (11,148 U/ml). Computed tomography showed swelling of the pancreas, and endoscopic retrograde cholangiopancreatography revealed diffuse irregular narrowing of the main pancreatic duct, which are typical findings of autoimmune pancreatitis. There was no evidence of malignancy. Administration of 30 mg/day of prednisolone was started. Computed tomography showed significant regression in the size of the pancreas, and the stenosis of the main pancreatic duct was improved on ERCP. The serum level of DUPAN-2 was also markedly decreased after the treatment.
一名80岁女性因黄疸和肝功能障碍入院。发现她血清IgG4滴度高、类风湿因子阳性且DUPAN-2显著升高（11,148 U/ml）。计算机断层扫描显示胰腺肿胀，内镜逆行胰胆管造影显示主胰管弥漫性不规则狭窄，这些都是自身免疫性胰腺炎的典型表现。没有恶性肿瘤的证据。开始给予泼尼松龙30毫克/天。计算机断层扫描显示胰腺大小显著缩小，内镜逆行胰胆管造影显示主胰管狭窄改善。治疗后DUPAN-2血清水平也明显下降。
