Abstract

OLIVEIRA, Juliana; JORGE, Gorete; MILHEIRO, António  and  SOUSA, Francisco Castro. Autoimmune pancreatitis and differential diagnosis with neoplasm of the pancreas: Based on a clinical case. J Port Gastrenterol. [online]. 2012, vol.19, n.1, pp.42-46. ISSN 0872-8178.

The Autoimmune pancreatitis (AIP) is a type of chronic pancreatitis characterized histologically by a lymphoplasmocytic infiltration and periductal fibrosis. The clinical presentation may mimic a carcinoma of the head of the pancreas, especially in cases of cephalic disease, characterized by obstructive jaundice, abdominal pain and weight loss. This clinical entity may be associated with other autoimmune diseases and the diagnosis is based on the diagnostic criteria suggested by Mayo Clinic and the Japanese Society of the Pancreas, which associate the histological and radiological features to the increase in IgG4 and response to treatment with corticosteroids. We present a case report of a patient who underwent a cephalic pancreatoduodenectomy, due to a preoperative diagnosis (clinical and radiological) of carcinoma of the head of the pancreas. The pathological study revealed that it was a lymphoplasmocytic pancreatitis and immunological study later confirmed the diagnosis of Auto Immune Pancreatitis. This article aims to raise awareness for the differential diagnosis with carcinoma of the head of the pancreas, to avoid performing a surgery with relevant morbidity and mortality rates in a disease sensitive to treatment with corticosteroids

Keywords : Autoimmune pancreatitis; carcinoma of the head of the pancreas; obstructive jaundice; lymphoplasmocytic infiltration; IgG4; cephalic pancreatoduodenectomy.

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