A Case of Focal Autoimmune Chronic Pancreatitis Improved with Oral Steroid Therapy / 대한소화기내시경학회지

Clinically, patients with pancreatic cancer and focal autoimmune chronic pancreatitis share many features, such as being elderly, painless jaundice, new-onset diabetes mellitus, and weight loss. Hence, it is difficult to differentiate between the two conditions. Nevertheless, it is very important to distinguish between focal autoimmune chronic pancreatitis and pancreatic cancer because they have different treatment modalities and prognoses. We encountered a case of a 72-year-old man who developed painless jaundice. The patient was diagnosed with focal autoimmune chronic pancreatitis instead of pancreatic cancer from the CT, ERCP, MRCP findings accompanying with an increased IgG4 level. The abnormalities in the clinical, laboratory, and radiological findings improved after 2 weeks of oral steroid treatment. After 3 months of oral steroid treatment, his disease showed further improvement. To our knowledge, this is a rare case of focal autoimmune chronic pancreatitis that improved with oral steroid treatment.

Diagnostic Criteria for Autoimmune Chronic Pancreatitis / 한양의대학술지

Autoimmune chronic pancreatitis (AIP) is a very attractive disease and increasingly being recognized to be a worldwide entity. Since the Japan Pancreas Society published diagnostic criteria for autoimmune chronic pancreatitis in 2002, increased attention toward this interesting disease has allowed the correct diagnosis of pancreatitis of previously unknown etiology, resulting in proper management and avoidance of surgery. Since the first case of AIP was reported in Asan medical center, Korea in 2002, more than 40 cases have been diagnosed until present. Accumulation of previously unrecognized or misdiagnosed cases of autoimmune chronic pancreatitis has revealed an increasing number of cases which are not fully compatible with the Japanese diagnostic criteria. Several institutes have, therefore, made and used their own criteria in the reporting of autoimmune chronic pancreatitis and the JPS criteria has also undergone revision recently. In this review, we discuss and compare the six current diagnostic criteria, discussing their own weak and strong points and then proposed a newly revised Kim's criteria.

A case of autoimmune chronic pancreatitis associated with sjogren's syndrome / 대한내과학회지

We report a case of autoimmune chronic pancreatitis associated with Sjogren's syndrome. A 68-year-old man was admitted to the hospital with jaundice. The serum IgG and IgE were elevated and endoscopic retrograde cholangiopancreatography demonstrated an irregular narrowing of the main pancreatic duct and stricture of the distal common bile duct. He complained of dry mouth and dry eyes with a gritty feeling. On physical examination, enlargement of both submandibular glands was noted. Schirmer test revealed positive result and the labial minor salivary gland biopsy showed infiltration of lymphocytes and plasma cells, consistent with Sjogren's syndrome. After one month of oral steroid therapy, the abnormalities in clinical, laboratory and radiological findings of autoimmune chronic pancreatitis were improved markedly. The enlargement of both submandibular glands was improved, too. To our knowledge, this is the first case of autoimmune chronic pancreatitis associated with Sjogren's syndrome in Korea.