Pancreatic Tuberculosis or Autoimmune Pancreatitis

Salahuddin, Ayesha; Saif, Muhammad Wasif

doi:10.1155/2014/410142

Cited by 17 publications

(16 citation statements)

References 30 publications

(36 reference statements)

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“…PCR assay is helpful in diagnosis, and laparotomy can be avoided. Ayesha et al [69] and Chatterji et al [60] utilized PCR assay in conjunction with EUS-guided FNAC to diagnose pancreatic tuberculosis. PCR assay in conjunction with other non-invasive modalities is helpful in diagnosing pancreatic tuberculosis.…”

Section: Role Of Polymerase Chain Reactionmentioning

confidence: 99%

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Pancreatic Tuberculosis

2015

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Tuberculosis of the pancreas is extremely rare and in most of the cases mimics pancreatic carcinoma. There are a number of case reports on pancreatic tuberculosis with various different presentations, but only a few case series have been published, and most of our knowledge about this disease comes from individual case reports. Patients of pancreatic tuberculosis may remain asymptomatic initially and manifest as an abscess or a mass involving local lymph nodes and usually present with non-specific features. Pancreatic tuberculosis may present with a wide range of imaging findings. It is difficult to diagnose tuberculosis of pancreas on imaging studies as they may present with masses, cystic lesions or abscesses and mass lesions in most of the cases mimic pancreatic carcinoma. As it is a rare entity, it cannot be recommended but suggested that pancreatic tuberculosis should be considered in cases with a large space occupying lesions associated with necrotic peripancreatic lymph nodes and constitutional sympt o m s . U l t r a s o n o g r a p h y / c o m p u t e d t o m o g r a p h y / endosonography-guided biopsy is the recommended diagnostic technique. Most patients achieve complete cure with standard antituberculous therapy. The aims of this study are to review clinical presentation, diagnostic studies, and management of pancreatic tuberculosis and to present our experience of 5 cases of pancreatic tuberculosis.

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Section: Role Of Polymerase Chain Reactionmentioning

confidence: 99%

“…Careful monitoring for drug-induced hepatitis may obviate fatality. For follow-up and guiding clinicians regarding complete resolution and duration of therapy, CT imaging is helpful [69]. In a retrospective study by Kim et al [71], out of 42 patients with pancreatic tuberculosis, only 1 patient had progressive disease on CT imaging.…”

Section: Treatmentmentioning

confidence: 99%

Pancreatic Tuberculosis

2015

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“…[9][10][11] Not only does pancreatic tuberculosis mimic pancreatic cancer, it also causes diagnostic confusion with other pancreatic disorders like pancreatic cystic neoplasms, chronic pancreatitis, and autoimmune pancreatitis. 7,[12][13][14][15][16][17] Because the disease is uncommon even in the regions endemic for tuberculosis, the diagnosis is often missed or delayed in most cases. Most reports of pancreatic tuberculosis indicate a preponderance of males in the reported cases except for two reports from China and South Korea.…”

Section: Clinical Presentation and Laboratory Findingsmentioning

confidence: 99%

“…The initiation phase of the therapy consists of intensive therapy with multiple drugs (rifampin, isoniazid, pyrazinamide, and ethambutol) given daily for 2 months, and this is followed by a continuation phase of at least 4 months with rifampin and isoniazid. The usual dosages for rifampin, isoniazid, pyrazinamide, and ethambutol are 10 mg/kg/day (8-12 mg/kg/day), 5 (4-6) mg/kg/day, 25 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) mg/kg/day, and 15 (15)(16)(17)(18)(19)(20) mg/kg/day respectively. In contrast to other forms of tuberculosis like pulmonary and intestinal, there is no data regarding use of intermittent therapy for pancreatic tuberculosis.…”

Section: Treatment Of Pancreatic Tuberculosismentioning

confidence: 99%

Pancreatic tuberculosis

Sharma

Rana

Kumar

et al. 2016

J of Gastro and Hepatol

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Pancreatic tuberculosis is very rare, but recently, there has been a spurt in the number of reports on pancreatic involvement by tuberculosis. It closely mimics pancreatic cancer, and before the advent of better imaging modalities it was often detected as a histological surprise in patients resected for a presumed pancreatic malignancy. The usual presentation involves abdominal pain, loss of appetite and weight, jaundice which can be associated with cholestasis, fever and night sweats, palpable abdominal lump, and peripheral lymphadenopathy. Computed tomography (CT) of the abdomen is an important tool for evaluation of patients with pancreatic tuberculosis. This CT imaging yields valuable information about the size and nature of tubercular lesions along with the presence of ascites and lymphadenopathy. However, there are no distinctive features on CT that distinguish it from pancreatic carcinoma. Endoscopic ultrasound provides high resolution images of the pancreatic lesions as well as an opportunity to sample these lesions for cytological confirmation. The presence of granulomas is the most common finding on histological/cytological examination with the presence of acid fast bacilli being observed only in minority of patients. As there are no randomized or comparative studies on treatment of pancreatic tuberculosis it is usually treated like other forms of tuberculosis. Excellent cure rates are reported with standard anti tubercular therapy given for 6-12 months.

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“…Previous reports have shown that open surgery or laparotomy is often necessary to confirm such diagnoses (4)(5)(6). Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) is becoming increasingly established as a minimally-invasive alternative to open surgery for the purpose of diagnostic confirmation; more recently, the utility of EUS-FNAB in the diagnosis of pancreatic TB has also begun to be reported as well (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Peripancreatic Tuberculous Lymphadenitis with Biliary Obstruction Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy

et al. 2016

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A 57-year-old man with a history of tuberculosis (TB) was found to have a pancreatic head mass, accompanied by stenosis of the common bile duct. Due to the inherent difficulty in differentiating pancreatic carcinoma from an inflammatory mass, endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) was thus performed. The pathological findings confirmed granuloma with caseous necrosis, and the results of the QuantiFERON TB2G test were positive. Accordingly, the patient was diagnosed with peripancreatic TB and thereafter was successfully treated with anti-TB therapy. Based on the findings of this case, we conclude that EUS-FNAB is a useful modality for the diagnosis of pancreatic TB.

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Pancreatic Tuberculosis or Autoimmune Pancreatitis

Cited by 17 publications

References 30 publications

Pancreatic Tuberculosis

Pancreatic Tuberculosis

Pancreatic tuberculosis

Peripancreatic Tuberculous Lymphadenitis with Biliary Obstruction Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy

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