Autoimmune pancreatitis diagnosed after pancreatoduodenectomy and successfully treated with low-dose steroid

Masato Watanabe, Koji Yamaguchi, Kiichiro Kobayashi, Hiroyuki Konomi, Masafumi Nakamura, Kazuhiro Mizumoto, Masazumi Tsuneyoshi, Masao Tanaka

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 69-year-old woman presented with obstructive jaundice and a 30-mm hypoechoic mass in the pancreatic head on ultrasonography. Magnetic resonance imaging (MRI) revealed enlargement of the pancreatic head with dilatation of the upstream main pancreatic duct and no dilatation of the proximal biliary tree. Endoscopic retrograde pancreatography showed a localized irregular narrowing of the main pancreatic duct in the head of the pancreas. Pylorus-preserving pancreatoduodenectomy (PPPD) was performed under the diagnosis of pancreatic head cancer. Histopathological examination showed fibrosis with lymphoplasmacytic infiltration, suggesting the diagnosis of autoimmune pancreatitis (AIP). Serum IgG concentration was within normal limits immediately after the operation but was elevated 4 months later, when MRI showed enlargement of the remnant pancreas, with a peripheral rim of low intensity. Oral administration of prednisolone was initiated, at a dose of 5 mg/day. The serum IgG concentration declined and MRI showed improvement of the pancreatic enlargement and the disappearance of the peripheral rim. AIP has not relapsed for 1 year so far, with the patient being kept on 5 mg/ day prednisolone. This communication reports a patient with AIP showing an interesting clinical course.

Original languageEnglish
Pages (from-to)397-400
Number of pages4
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume14
Issue number4
DOIs
Publication statusPublished - Jul 1 2007

Fingerprint

Pancreaticoduodenectomy
Pancreatitis
Pancreatic Ducts
Steroids
Magnetic Resonance Imaging
Prednisolone
Dilatation
Pancreas
Immunoglobulin G
Obstructive Jaundice
Pylorus
Biliary Tract
Head and Neck Neoplasms
Serum
Pancreatic Neoplasms
Oral Administration
Ultrasonography
Fibrosis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology

Cite this

Autoimmune pancreatitis diagnosed after pancreatoduodenectomy and successfully treated with low-dose steroid. / Watanabe, Masato; Yamaguchi, Koji; Kobayashi, Kiichiro; Konomi, Hiroyuki; Nakamura, Masafumi; Mizumoto, Kazuhiro; Tsuneyoshi, Masazumi; Tanaka, Masao.

In: Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 14, No. 4, 01.07.2007, p. 397-400.

Research output: Contribution to journalArticle

Watanabe, Masato ; Yamaguchi, Koji ; Kobayashi, Kiichiro ; Konomi, Hiroyuki ; Nakamura, Masafumi ; Mizumoto, Kazuhiro ; Tsuneyoshi, Masazumi ; Tanaka, Masao. / Autoimmune pancreatitis diagnosed after pancreatoduodenectomy and successfully treated with low-dose steroid. In: Journal of Hepato-Biliary-Pancreatic Surgery. 2007 ; Vol. 14, No. 4. pp. 397-400.
@article{53b3913be4534522ad746e64c7dbd35e,
title = "Autoimmune pancreatitis diagnosed after pancreatoduodenectomy and successfully treated with low-dose steroid",
abstract = "A 69-year-old woman presented with obstructive jaundice and a 30-mm hypoechoic mass in the pancreatic head on ultrasonography. Magnetic resonance imaging (MRI) revealed enlargement of the pancreatic head with dilatation of the upstream main pancreatic duct and no dilatation of the proximal biliary tree. Endoscopic retrograde pancreatography showed a localized irregular narrowing of the main pancreatic duct in the head of the pancreas. Pylorus-preserving pancreatoduodenectomy (PPPD) was performed under the diagnosis of pancreatic head cancer. Histopathological examination showed fibrosis with lymphoplasmacytic infiltration, suggesting the diagnosis of autoimmune pancreatitis (AIP). Serum IgG concentration was within normal limits immediately after the operation but was elevated 4 months later, when MRI showed enlargement of the remnant pancreas, with a peripheral rim of low intensity. Oral administration of prednisolone was initiated, at a dose of 5 mg/day. The serum IgG concentration declined and MRI showed improvement of the pancreatic enlargement and the disappearance of the peripheral rim. AIP has not relapsed for 1 year so far, with the patient being kept on 5 mg/ day prednisolone. This communication reports a patient with AIP showing an interesting clinical course.",
author = "Masato Watanabe and Koji Yamaguchi and Kiichiro Kobayashi and Hiroyuki Konomi and Masafumi Nakamura and Kazuhiro Mizumoto and Masazumi Tsuneyoshi and Masao Tanaka",
year = "2007",
month = "7",
day = "1",
doi = "10.1007/s00534-006-1179-0",
language = "English",
volume = "14",
pages = "397--400",
journal = "Journal of Hepato-Biliary-Pancreatic Sciences",
issn = "1868-6974",
publisher = "Springer Verlag",
number = "4",

}

TY - JOUR

T1 - Autoimmune pancreatitis diagnosed after pancreatoduodenectomy and successfully treated with low-dose steroid

AU - Watanabe, Masato

AU - Yamaguchi, Koji

AU - Kobayashi, Kiichiro

AU - Konomi, Hiroyuki

AU - Nakamura, Masafumi

AU - Mizumoto, Kazuhiro

AU - Tsuneyoshi, Masazumi

AU - Tanaka, Masao

PY - 2007/7/1

Y1 - 2007/7/1

N2 - A 69-year-old woman presented with obstructive jaundice and a 30-mm hypoechoic mass in the pancreatic head on ultrasonography. Magnetic resonance imaging (MRI) revealed enlargement of the pancreatic head with dilatation of the upstream main pancreatic duct and no dilatation of the proximal biliary tree. Endoscopic retrograde pancreatography showed a localized irregular narrowing of the main pancreatic duct in the head of the pancreas. Pylorus-preserving pancreatoduodenectomy (PPPD) was performed under the diagnosis of pancreatic head cancer. Histopathological examination showed fibrosis with lymphoplasmacytic infiltration, suggesting the diagnosis of autoimmune pancreatitis (AIP). Serum IgG concentration was within normal limits immediately after the operation but was elevated 4 months later, when MRI showed enlargement of the remnant pancreas, with a peripheral rim of low intensity. Oral administration of prednisolone was initiated, at a dose of 5 mg/day. The serum IgG concentration declined and MRI showed improvement of the pancreatic enlargement and the disappearance of the peripheral rim. AIP has not relapsed for 1 year so far, with the patient being kept on 5 mg/ day prednisolone. This communication reports a patient with AIP showing an interesting clinical course.

AB - A 69-year-old woman presented with obstructive jaundice and a 30-mm hypoechoic mass in the pancreatic head on ultrasonography. Magnetic resonance imaging (MRI) revealed enlargement of the pancreatic head with dilatation of the upstream main pancreatic duct and no dilatation of the proximal biliary tree. Endoscopic retrograde pancreatography showed a localized irregular narrowing of the main pancreatic duct in the head of the pancreas. Pylorus-preserving pancreatoduodenectomy (PPPD) was performed under the diagnosis of pancreatic head cancer. Histopathological examination showed fibrosis with lymphoplasmacytic infiltration, suggesting the diagnosis of autoimmune pancreatitis (AIP). Serum IgG concentration was within normal limits immediately after the operation but was elevated 4 months later, when MRI showed enlargement of the remnant pancreas, with a peripheral rim of low intensity. Oral administration of prednisolone was initiated, at a dose of 5 mg/day. The serum IgG concentration declined and MRI showed improvement of the pancreatic enlargement and the disappearance of the peripheral rim. AIP has not relapsed for 1 year so far, with the patient being kept on 5 mg/ day prednisolone. This communication reports a patient with AIP showing an interesting clinical course.

UR - http://www.scopus.com/inward/record.url?scp=34547593598&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547593598&partnerID=8YFLogxK

U2 - 10.1007/s00534-006-1179-0

DO - 10.1007/s00534-006-1179-0

M3 - Article

C2 - 17653640

AN - SCOPUS:34547593598

VL - 14

SP - 397

EP - 400

JO - Journal of Hepato-Biliary-Pancreatic Sciences

JF - Journal of Hepato-Biliary-Pancreatic Sciences

SN - 1868-6974

IS - 4

ER -