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- W2044482069 abstract "A 41-year-old woman was admitted to our hospital with abdominal pain and jaundice. Laboratory data revealed liver dysfunction with hyperbilirubimemia and an elevated level of serum IgG4. Abdominal CT demonstrated diffuse pancreatic swelling and a thickened intra-pancreatic bile duct wall, and ERCP revealed stenosis of the main pancreatic and bile ducts. On the third day after steroid therapy, 18-fluorodeoxyglucose positron emission tomography (FDG-PET) scans revealed decreased accumulation of FDG compared with pre-treatment levels. Differentiating AIP from pancreatic cancer may be difficult in some cases and pancreatic cancer cannot be ruled out even when the diagnostic criteria for AIP are satisfied. Since pancreatic cancer is sometimes accompanied with AIP, the differential diagnosis requires extreme caution. During the active phase of AIP, FDG-PET has been reported to detect FDG accumulation, which decreases when inflammation is alleviated. In addition, FDG accumulation decreases, even in extrapancreatic lesions, after steroid therapy. The accumulation of FDG in pancreatic cancer is diagnostically useful and it is believed not to diminish after PSL administration1). Thus, AIP might be differentiated from pancreatic cancer based on the responses to steroid therapy. Previous studies of PET for AIP assessed the responses several months after starting therapy2). However, a repeat PET scan for AIP within a week after steroid therapy revealed a significantly decreasing SUV in our patient. Thus, follow-up FDG-PET seems useful for assessing the early response of AIP to steroid therapy and for differentiating AIP from pancreatic cancer.FIGURE 1: 18-Fluorodeoxyglucose positron emission tomography (FDG-PET) showed remarkably decreasing levels of FDG accumulation 3 days after starting steroid therapy. A, Whole FDG-PET before steroid therapy shows FDG accumulation in the pancreas and extra pancreatic lesions. B, Whole FDG-PET after steroid therapy shows FDG accumulation in the pancreas and extra pancreatic lesions." @default.
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- W2044482069 date "2010-07-01" @default.
- W2044482069 modified "2023-10-16" @default.
- W2044482069 title "Accumulation of FDG Due to Autoimmune Pancreatitis Distinctly Decreased After Steroid Therapy" @default.
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- W2044482069 doi "https://doi.org/10.1097/01.mpa.0000371182.81000.b6" @default.
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