Wegener's Granulomatosis with Onset of Acute Pancreatitis and Rapid Progress

Matsubayashi, Hiroyuki; Seki, Tomotsugu; Niki, Shuji; Mizumura, Yasuo; Taguchi, Yumiko; Go, Kiyoe

doi:10.1159/000055821

Cited by 19 publications

(14 citation statements)

References 21 publications

(28 reference statements)

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“…All 10 cases included a pathological diagnosis of vasculitis, 5 of which presented with acute pancreatitis and were diagnosed via biopsy of other sites. One patient died of severe pancreatitis,15 whereas the conditions of the others improved after postoperative treatment with a glucocorticoid and cyclophosphamide or azathioprine. Two cases were diagnosed preoperatively and treated with a glucocorticoid and cyclophosphamide; one of which also included peritoneal dialysis 5 16.…”

Section: Discussionmentioning

confidence: 97%

Microscopic polyangiitis masquerading as a pancreatic neoplasm with multiple lung metastases

et al. 2019

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A 71-year-old man was admitted to our hospital with right lower abdominal pain. Blood analysis indicated severe inflammation, and abdominal CT revealed a pancreatic head tumour and multiple lung nodules. The level of a tumour marker was high. Pancreatic cancer with multiple lung metastases was suspected; however, because the mass was not detected via endoscopic ultrasonography, it was not biopsied. The serum creatinine level increased rapidly with a urine disorder, and myeloperoxidase-antineutrophil cytoplasmic antibody staining was positive. Severe rapidly progressive glomerulonephritis (RPGN) and microscopic polyangiitis were diagnosed, and high-dose glucocorticoid treatment was started. The patient’s high fever returned to normal, and the serum creatinine level declined. Because the RPGN was severe, cyclophosphamide was administrated, and the glucocorticoid was tapered. The pancreatic tumour regressed, the lung nodules disappeared, and the tumour marker level normalised during the treatment. Renal function improved, and maintenance haemodialysis was avoided.

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Section: Discussionmentioning

confidence: 97%

Microscopic polyangiitis masquerading as a pancreatic neoplasm with multiple lung metastases

et al. 2019

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“…It may present as a tumor-like lesion (4-6), acute pancreatitis (7-9) or exocrine pancreatic insufficiency (10). Very seldom, pancreatic involvement represented the initial manifestation of the disease (4,5,7). Two out of the three cases described showed a rapid progressive course (5,7); the third was promptly treated with cyclophosphamide and corticosteroid therapy (4).…”

Section: Discussionmentioning

confidence: 99%

Two cases of Wegener’s granulomatosis with pancreatic pseudocyst treated by endoscopic ultrasonography (EUS)-guided drainage

Şahin

Cındoruk

Karakan³

et al. 2012

Turk J Gastroenterol

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“…A broad differential diagnosis must be kept in mind when establishing a diagnosis in a patient with a mass-forming pancreatic lesion [ 10 , 11 , 12 , 13 ]. Time is of essence as many of these lesions grow rapidly [ 10 , 11 , 12 ] and the consequences of an accurate diagnosis are significant as therapy will vary greatly from high-dose chemotherapy to immunosuppression [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Pancreatitis Accompanied by Cholecystitis, Periaortitis and Pseudotumors of the Liver

Matsubayashi¹,

Furukawa²,

Uesaka³

et al. 2008

Case Rep Gastroenterol

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A variety of extrapancreatic lesions have been associated with autoimmune pancreatitis (AIP), and these lesions can be difficult to diagnose. We report a patient referred to Shizuoka Cancer Center with the diagnosis of a possible biliary carcinoma with liver metastasis who was shown to have AIP accompanied by pseudotumors of liver. Clinical imaging revealed diffuse enlargement of the head of the pancreas with irregular narrowing of the main pancreatic duct and inferior common bile duct, multiple liver masses, mediastinal lymphadenopathy, and thickening of the wall of the gallbladder and abdominal aorta. Cytology and biopsy from the pancreaticobiliary tract was negative for malignancy. Serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) levels were in the normal range, but soluble interleukin 2 receptor (sIL2R), IgG4 and antinuclear antibody were abnormally high (sIL2R: 2,550 U/ml; IgG4: 764 mg/dl). Corticosteroid therapy was effective and these abnormal findings all improved. This case demonstrates the clinical importance of AIP accompanied by other systemic disorders in the differential diagnosis of patients with a pancreatic mass lesion.

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Wegener's Granulomatosis with Onset of Acute Pancreatitis and Rapid Progress

Cited by 19 publications

References 21 publications

Microscopic polyangiitis masquerading as a pancreatic neoplasm with multiple lung metastases

Microscopic polyangiitis masquerading as a pancreatic neoplasm with multiple lung metastases

Two cases of Wegener’s granulomatosis with pancreatic pseudocyst treated by endoscopic ultrasonography (EUS)-guided drainage

Autoimmune Pancreatitis Accompanied by Cholecystitis, Periaortitis and Pseudotumors of the Liver

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