Relabující autoimunitní pankreatitida 1. typu: kazuistika
| Title in English | Relapsing autoimmune pancreatitis type 1: Case report |
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| Authors | |
| Year of publication | 2017 |
| Type | Article in Periodical |
| Magazine / Source | Vnitřní lékařství |
| MU Faculty or unit | |
| Citation | |
| Field | Other medical specializations |
| Keywords | Autoimmune pancreatitis type 1; Long-term follow-up; Relapse; Therapy |
| Description | Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, classifed into 2 subtypes-AIP type 1 and AIP type 2. We present a case of a 31-years-old female admitted to our institution with upper abdominal pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatoscopy (ERCP) revealed stenosis of intrapancreatic distal bile duct. Difuse parenchymal enlargement and typical features of AIP were shown by computed tomography (CT) and endoscopic ultrasonography (EUS). The patients serum IgG4 was elevated at 3.8 g/l (range 0.08-1.4 g/l). She was diagnosed with AIP type 1 and treated with prednisone (initial dose of 30 mg per day, then tapered by 5 mg/day every week). The maintenance dose of 5 mg per day was continued for 6 months. Despite clinical and radiological remission, serum levels of IgG4 remained elevated. The patient experienced disease relapse 25 months after frst attack. Moreover, new fnding of calcifcations occured in pancreas. The relapse was managed with corticosteroids and maintenance immunosupression with azathioprin was started. Literature review on risk factor of relapse, long-term immunosupressive therapy indication and optimal follow-up of AIP type 1 patients are discussed. |
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