Presentation
Abdominal pain with recurrent pancreatitis. Evaluate for complications.
Patient Data
Age: 65 years
Gender: Male
From the case:
IgG4-related autoimmune pancreatitis and cholangitis
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Diffuse enlargement of the pancreas with minimal surrounding haziness/fluid. Perhaps some low-attenuation "halo" near the tail.
Concentric thickening and enhancement of the common bile duct.
Case Discussion
Serum IgG4 levels (checked after interpreting radiologist raised concern of IgG4-related disease) = 1000 mg/dL (normal 8-140 mg/dL). Range of IgG4 values in AIP = 1234 +/-13471.
What findings should make you think about autoimmune/IgG4-related pancreatitis?
- diffuse pancreatic enlargement
- minimal peripancreatic inflammation/fluid
- concentric thickening and enhancement of the common bile duct, indicating autoimmune cholangitis
Timely diagnosis is of great benefit to patients, as they can usually be managed with steroids alone.
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