Dogan Guzide, Akgun Ozlem, Ozdemir Sevim, Uzuner Esen Gul, Poturoglu Sule
Health Science University Haseki Training and Research Hospital, Depertment of Pediatric Gastroenterology, Istanbul, Turkey.
Health Science University Haseki Training and Research Hospital Depertment of Pediatrics, Istanbul, Turkey.
Medeni Med J. 2020;35(1):62-66. doi: 10.5222/MMJ.2020.02347. Epub 2020 Feb 28.
Although autoimmune pancreatitis is not seen in children frequently, it is included in the etiology of chronic pancreatitis. A 16-year-old girl who was diagnosed with chronic pancreatitis 4 months previously, presented to the outpatient clinic with abdominal pain on the epigastric region, and left lower abdominal quadrant and bloody defecation. Remarkable laboratory test results were as follows: amylase: 109 U/L, lipase: 196 U/L, Ig G:13.70 g/L, IgG4:2.117 g/L, fecal calprotectin 573 μg/g. In the MRCP examination, revealed enlarged pancreas with a heterogeneous appearance, dilated main pancreatic duct. Colonoscopic and histopathological findings were consistent with inflammatory bowel disease. The case was diagnosed as Crohn's disease coursing with autoimmune pancreatitis. Clinical and laboratory findings regressed after steroid treatment. Autoimmune pancreatitis is important in that it is rarely seen in children and though less frequently it is associated with Crohn's disease. It should be kept in mind that inflammatory bowel disease may develop in the follow-up of autoimmune pancreatitis and autoimmune pancreatitis may be present in the etiology of chronic pancreatitis.
尽管自身免疫性胰腺炎在儿童中并不常见，但它包含在慢性胰腺炎的病因之中。一名4个月前被诊断为慢性胰腺炎的16岁女孩，因上腹部、左下腹疼痛及便血就诊于门诊。显著的实验室检查结果如下：淀粉酶：109 U/L，脂肪酶：196 U/L，IgG：13.70 g/L，IgG4：2.117 g/L，粪便钙卫蛋白573 μg/g。在磁共振胰胆管造影（MRCP）检查中，显示胰腺肿大，外观不均匀，主胰管扩张。结肠镜检查和组织病理学检查结果与炎症性肠病一致。该病例被诊断为克罗恩病合并自身免疫性胰腺炎。类固醇治疗后临床和实验室检查结果好转。自身免疫性胰腺炎很重要，因为它在儿童中很少见，而且虽不常见但与克罗恩病有关。应牢记在自身免疫性胰腺炎的随访中可能会发生炎症性肠病，且自身免疫性胰腺炎可能存在于慢性胰腺炎的病因中。
