Muñoz C Sergio, Mancilla A Carla, Moyano S Leonor, Castillo T Cecilia, Rossi F Ricardo, Brahm B Javier, Berger F Zoltán
Sección de Gastroenterología, Departamento de Medicina Interna, Hospital Clínico, Universidad de Chile.
Rev Med Chil. 2010 Mar;138(3):295-302. Epub 2010 May 19.
Autoimmune pancreatitis is a special form of chronic pancreatitis, more common in men and usually presenting as obstructive jaundice or abdominal pain. It may be associated with other immunological disorders and sometimes it is possible to find positive serological markers. Typical images show pancreatic enlargement with focal or diffuse stenosis of the pancreatic duct but sometimes it presents as a focal pancreatic mass that is difficult to differentiate from pancreatic carcinoma.
To report ten cases of autoimmune pancreatitis.
Retrospective review of clinical records of 10 patients aged 26 to 56 years (six males) with autoimmune pancreatitis.
The clinical presentation was obstructive jaundice in six cases, acute pancreatitis in two, persistent increase in serum amylase and Upase in one, and permanent abdominal pain and weight loss in one. On imaging studies, a circumscribed mass was founded in six patients. An endoscopic retrograde colangiopancreatography was performed in four patients showing an abnormal pancreatic duct in all. Six patients were operated and tissue for pathological study was obtained in five, showing inflammatory infiltration. Vive patients were treated with steroids with a good clinical response.
Autoimmune pancreatitis must be borne in mind in the differential diagnosis of pancreatic lesions.
自身免疫性胰腺炎是慢性胰腺炎的一种特殊形式，男性更为常见，通常表现为梗阻性黄疸或腹痛。它可能与其他免疫性疾病相关，有时可发现血清学标志物呈阳性。典型影像表现为胰腺肿大伴胰管局限性或弥漫性狭窄，但有时表现为局灶性胰腺肿块，难以与胰腺癌鉴别。
报告10例自身免疫性胰腺炎病例。
回顾性分析10例年龄在26至56岁（6例男性）的自身免疫性胰腺炎患者的临床记录。
临床表现为梗阻性黄疸6例，急性胰腺炎2例，血清淀粉酶和脂肪酶持续升高1例，持续性腹痛和体重减轻1例。影像学检查发现6例患者有边界清楚的肿块。4例患者行内镜逆行胰胆管造影，均显示胰管异常。6例患者接受手术治疗，5例获取组织进行病理研究，显示有炎症浸润。5例患者接受类固醇治疗，临床反应良好。
在胰腺病变的鉴别诊断中必须考虑自身免疫性胰腺炎。
