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- W2913176975 abstract "Introduction: Autoimmune pancreatitis (AIP) is form of chronic pancreatitis characterized by a dramatic response to steroid therapy. The most frequent symptom at the time of diagnosis is painless obstructive jaundice. The most typical appearance of AIP is a diffuse enlargement of the pancreas, described in 40% of the patients. However, AIP may also manifest as a focal enlargement of the pancreas that would appear like a pancreatic mass. Here we describe a case of AIP that was first suspected to represent malignancy. Case Presentation: This patient is a 63-year-old man who presented to the emergency department with a complaint of abdominal pain. He was found to have elevated liver enzymes, especially bilirubin and alkaline phosphatase. The patient did not have stigmata of pancreatic cancer; he denied weight loss or change in appetite. CBC showed a hemoglobin of 13.9, platelet count of 212, WBCs 6.7. CMP showed Na 136, K+ 4.6. His Total Bilirubin was 4.2, his Alkaline Phosphatase 400 and his CA 19-9 5.0, the IgG4 level 24. CT abdomen showed a prominent mass in the head of the pancreas, which was suspicious for malignancy. An ERCP with stent placement was done, and an EUS-guided biopsy was taken, which came back positive for lymphoplasmacytic sclerosing pancreatitis, a finding typical of type 1 AIP. Discussion: An increasingly common problem that medical professionals encounter is distinguishing autoimmune pancreatitis from pancreatic cancer. CT scan and MRI are used to detect parenchymal changes, while ERCP and MRCP are used for detecting ductal changes. Ruling out malignancy may be tough in certain cases, but the use of contrast CT scan is a significant imaging test that may clinch a diagnosis. The presence of a capsule-like rim around the pancreas is a finding reported to have high specificity for AIP. We recommend a stepwise approach in differentiating AIP from malignancy as 30% of patients, especially those with Type 2 AIP, can present with what appears to be a pancreatic mass." @default.
- W2913176975 created "2019-02-21" @default.
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- W2913176975 date "2017-10-01" @default.
- W2913176975 modified "2023-09-25" @default.
- W2913176975 title "Suspected Malignant Pancreatic Mass Turns Out to be Autoimmune Pancreatitis" @default.
- W2913176975 doi "https://doi.org/10.14309/00000434-201710001-01351" @default.
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