Autoimmune Pancreatitis: From Pathogenesis to Treatment

Obstructive jaundice is a joint clinical presentation with many etiologies, including pancreatic cancer and autoimmune pancreatitis (AIP). Differentiating between these two conditions is pivotal due to the divergent management approaches and prognoses. In this case report, we present a case of a 49-year-old female patient who presented with weight loss, intermittent chronic abdominal pain, and jaundice. She was initially suspected of having pancreatic cancer because of clinical presentation and imaging findings. However, she was ultimately diagnosed with Type 1 AIP due to histopathology findings and elevated immunoglobulin G4. This case highlights the complexities in diagnosis, the role of advanced imaging techniques and tissue sampling, and the lessons learned regarding managing this challenging clinical scenario.

Section: Discussionsupporting

confidence: 57%

Type 1 Autoimmune Pancreatitis Masquerading as Pancreatic Head Carcinoma

Agboola,

Mohamed,

Syed

et al. 2023

“…The long-term prognosis for AIP patients is generally favorable, with most patients achieving and maintaining remission with appropriate treatment. However, disease relapse can occur in up to 50% of patients, and long-term monitoring is, therefore, recommended [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Pancreatitis Presenting as Obstructive Jaundice Mimicking Pancreatic Cancer: An Unusual Case Report

Suvvari¹,

Godavari²,

Sanapala³

et al. 2023

Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis that can be misdiagnosed as pancreatic cancer due to similar clinical and radiological findings. In this case report, we present a 49-year-old male patient who presented with obstructive jaundice and was initially diagnosed with pancreatic cancer based on imaging findings. However, the lack of definitive parenchymal tissue in the biopsy raised suspicion for an alternative diagnosis, which led to further testing and ultimately the diagnosis of AIP. The use of endoscopic ultrasonography (EUS) and fine needle biopsy (FNB) helped to obtain a tissue diagnosis and rule out malignancy. The measurement of serum IgG4 levels further supported the diagnosis of AIP. The patient was treated with glucocorticoids and showed gradual improvement, ultimately recovering from AIP. This case highlights the importance of maintaining a high level of suspicion and considering AIP as a possible diagnosis when investigating cases that mimic pancreatic cancer. Early recognition and treatment with steroids can result in a favorable outcome for patients with AIP.

“…Obstructive jaundice may be relieved by biliary drainage intervention [ 12 ]. The disease prognosis is favorable, as relapse is seen only in 50% of the patients, and most of the patients recover with effective treatment [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Obstructive Jaundice Mimicking Pancreatic Cancer: An Unusual Presentation of Autoimmune Pancreatitis

Ogunlaja,

Oni,

Ibeawuchi

et al. 2023

Autoimmune pancreatitis (AIP) is an uncommon variant of chronic pancreatitis characterized by inflammatory changes within the pancreatic tissue triggered by autoimmune mechanisms. It is known to mimic pancreatic cancer due to its similar clinical and radiological presentations. We underline a case of a 55-year-old male who presented with weight loss, jaundice, and pruritus. Radiological imaging suggested a pancreatic mass, raising suspicion of malignancy. However, subsequent evaluation, absence of parenchymal tissue and lymphoplasmacytic cells on endoscopic ultrasound-guided biopsy, and elevated serum immunoglobulin G4 level resulted in the diagnosis of AIP. Our case emphasizes that AIP should be included in the differential diagnosis of obstructive jaundice, especially when clinical and radiological findings are inconclusive for pancreatic cancer.