Amaral Susana Rocha, Elvas Luís, Pereira Tatiana, Jacinto Paula, Sousa Gabriela
Medical Oncology Department, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal.
Gastroenterology Department, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal.
Eur J Case Rep Intern Med. 2019 Aug 6;6(8):001205. doi: 10.12890/2019_001205. eCollection 2019.
Autoimmune pancreatitis has been associated with many syndromes in the presence of increased immunoglobulin levels. IgG4 antibodies are elevated in the context of lymphoplasmacytic sclerosing pancreatitis associated with IgG4-related disease. We present the case of a 74-year-old man diagnosed with autoimmune pancreatitis on a cancer background. Awareness of this condition in the cancer patient is crucial for timely diagnosis. Infectious complications might have implications for the choice of immunosuppressant.
Autoimmune pancreatitis can mimic pancreatic cancer, thus delaying diagnosis in patients with cancer.It is important to rule out malignancy and distinguish autoimmune pancreatitis from pancreatic cancer, but obtaining a sample of pancreatic tissue can be difficult.Steroids are the mainstay of initial treatment, but there is growing evidence for the use of other immunomodulators, such as rituximab, for induction and maintenance or as an option for patients at high risk of relapse.
自身免疫性胰腺炎在免疫球蛋白水平升高时与多种综合征相关。在与IgG4相关疾病相关的淋巴细胞浆细胞性硬化性胰腺炎中，IgG4抗体升高。我们报告一例74岁男性在癌症背景下被诊断为自身免疫性胰腺炎的病例。癌症患者对这种情况的认识对于及时诊断至关重要。感染性并发症可能会影响免疫抑制剂的选择。
自身免疫性胰腺炎可模仿胰腺癌，从而延迟癌症患者的诊断。排除恶性肿瘤并将自身免疫性胰腺炎与胰腺癌区分开来很重要，但获取胰腺组织样本可能很困难。类固醇是初始治疗的主要手段，但越来越多的证据表明，使用其他免疫调节剂，如利妥昔单抗，进行诱导和维持治疗，或作为复发高危患者的一种选择。
