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基于临床诊断的1型自身免疫性胰腺炎:病例报告

Type one autoimmune pancreatitis based on clinical diagnosis: A case report.

作者信息

Zhang Bi-Yu, Liang Mou-Wang, Zhang Shuang-Xi

机构信息

Department of Gastroenterology, Guangzhou University of Chinese Medicine Shunde Hospital, Foshan 528300, Guangdong Province, China.

Department of Gastroenterology, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China.

出版信息

World J Clin Cases. 2024 May 16;12(14):2438-2444. doi: 10.12998/wjcc.v12.i14.2438.

Abstract

BACKGROUND

Autoimmune pancreatitis (AIP) is a rare form of autoimmune-mediated pancreatitis, which is easily misdiagnosed as pancreatic cancer and thus treated surgically. We studied the diagnosis and treatment of a patient with type 1 AIP recently admitted to our hospital, and reviewed the literature to provide a reference for clinical diagnosis of AIP.

CASE SUMMARY

The chief complaint was yellowing of the body, eyes and urine for 21 d. The patient's clinical presentation was obstructive jaundice and imaging suggested pancreatic swelling. It was difficult to distinguish between inflammation and tumor. Serum immunoglobulin G4 (IgG4) was markedly elevated. IgG4 is an important serological marker for type 1 AIP. The patient was diagnosed with AIP, IgG4-related cholangitis, acute cholecystitis and hepatic impairment. After applying hormonal therapy, the patient's symptoms improved significantly. At the same time, imaging suggested that pancreatic swelling subsided, and liver function and other biochemical indicators decreased. The treatment was effective.

CONCLUSION

In patients with pancreatic swelling, the possibility of AIP should be considered.

摘要

背景

自身免疫性胰腺炎(AIP)是一种罕见的自身免疫介导的胰腺炎,容易被误诊为胰腺癌并因此接受手术治疗。我们研究了我院近期收治的1型AIP患者的诊断和治疗,并复习文献以提供AIP临床诊断的参考。

病例摘要

主要诉求为全身、眼睛和尿液发黄21天。患者临床表现为梗阻性黄疸,影像学提示胰腺肿大。难以区分炎症和肿瘤。血清免疫球蛋白G4(IgG4)显著升高。IgG4是1型AIP的重要血清学标志物。该患者被诊断为AIP、IgG4相关性胆管炎、急性胆囊炎和肝功能损害。应用激素治疗后,患者症状明显改善。同时,影像学提示胰腺肿大消退,肝功能及其他生化指标下降。治疗有效。

结论

对于胰腺肿大的患者,应考虑AIP的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b488/11099416/0267886fac26/WJCC-12-2438-g001.jpg

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