Fujiwara Michimasa
Pediatrics, National Hospital Organization Fukuyama Medical Center, Fukuyama, JPN.
Cureus. 2024 Nov 13;16(11):e73653. doi: 10.7759/cureus.73653. eCollection 2024 Nov.
Hereditary pancreatitis (HP) is an unusual form of pancreatitis inherited as an autosomal dominant disorder. Patients typically present with recurrent acute pancreatitis-like symptoms that eventually progress to chronic pancreatitis, resulting in pancreatic exocrine insufficiency or diabetes mellitus, and a high risk of developing pancreatic cancer. As such, early diagnosis is crucial. Herein, we present the case of an 11-year-old boy with no significant medical history, but a family history of type 1 diabetes and pancreatic cancer, who presented with intermittent epigastric pain and nausea. Imaging revealed multiple pancreatic pseudocysts, pancreatic stones, and pancreatic duct dilation, resulting in the diagnosis of acute-on-chronic pancreatitis. Genetic testing confirmed the presence of a mutation in the PRSS1 gene, ultimately resulting in the diagnosis of HP. The patient remained symptom-free for five years during follow-up post-treatment. This case highlights the importance of considering HP in young patients presenting with pseudocysts and other signs of chronic pancreatitis even during the initial acute episode.
遗传性胰腺炎(HP)是一种不常见的胰腺炎形式,作为常染色体显性疾病遗传。患者通常表现出反复发作的类似急性胰腺炎的症状,最终发展为慢性胰腺炎,导致胰腺外分泌功能不全或糖尿病,以及患胰腺癌的高风险。因此,早期诊断至关重要。在此,我们报告一例11岁男孩的病例,他没有明显的病史,但有1型糖尿病和胰腺癌家族史,出现间歇性上腹部疼痛和恶心。影像学检查发现多个胰腺假性囊肿、胰腺结石和胰管扩张,诊断为慢性胰腺炎急性发作。基因检测证实PRSS1基因存在突变,最终确诊为HP。该患者在治疗后的随访期间五年无症状。这个病例强调了即使在最初的急性发作期,对于出现假性囊肿和其他慢性胰腺炎体征的年轻患者考虑HP的重要性。