ABSTRACT
An 84-year-old man was referred to our hospital for a cystic lesion of the pancreatic head, swelling of the pancreatic tail and hilar biliary stricture, resulting in elevated liver enzyme levels. We suspected branch duct-type intraductal papillary mucinous neoplasm (IPMN) and type I autoimmune pancreatitis (AIP) associated with sclerosing cholangitis because of the high serum IgG4 levels. The main pancreatic duct on the tail side of the AIP lesion was moderately dilated. Although the biliary stricture and pancreatic swelling improved after prednisolone treatment, the pancreatic enzyme levels increased rapidly. The entire main pancreatic duct exhibited remarkable dilatation, which led to the diagnosis of mixed-type IPMN. The clinical characteristics of IPMN in the main pancreatic duct appear to have been initially masked by AIP.
Subject(s)
Autoimmune Pancreatitis , Carcinoma, Pancreatic Ductal , Pancreatic Neoplasms , Aged, 80 and over , Carcinoma, Pancreatic Ductal/complications , Carcinoma, Pancreatic Ductal/diagnosis , Humans , Immunoglobulin G , Male , Pancreas , Pancreatic Ducts , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnosisABSTRACT
A retrospective cohort study was performed to investigate the relationship between diabetic retinopathy and coronary artery disease in 371 Japanese adult patients with type 2 diabetes. We found that proliferative retinopathy was significantly associated with an increased risk of coronary artery disease, even after adjustment for classical coronary risk factors.
