Background: Type 2 autoimmune pancreatitis is characterized by multiple or segmental strictures of the main pancreatic duct without upstream dilatation. We encountered a case of mass-forming type 2 autoimmune pancreatitis with upstream main pancreatic duct dilatation that was difficult to diagnose preoperatively using endoscopic ultrasound sonography-guided fine-needle aspiration cytology.
Case Presentation: A 58-year-old Japanese man presented with recurrent acute pancreatitis secondary to a 10-mm pancreatic head tumor. The tumor compressed the main pancreatic duct, thereby dilating the upstream main pancreatic duct. The serum immunoglobin G4 levels were within normal limits. Endoscopic ultrasound sonography-guided fine-needle aspiration cytology was performed twice. However, few degenerative atypical cells were observed, resulting in an indeterminate diagnosis. The patient underwent pancreaticoduodenectomy, and pathological findings revealed duct-centric pancreatitis with neutrophilic infiltration of the interlobular pancreatic ductal epithelium. Immunoglobin G4-positive cells were not detected. The patient was diagnosed with type 2 autoimmune pancreatitis.
Conclusion: Mass-forming type 2 autoimmune pancreatitis can present with main pancreatic duct strictures and upstream dilatation. Although endoscopic ultrasound sonography-guided fine-needle aspiration cytology is useful for the diagnosis of solid pancreatic masses, preoperative diagnosis of type 2 autoimmune pancreatitis remains challenging. Further studies should be conducted to determine whether "hidden" type 2 autoimmune pancreatitis may be more frequently present and to improve the accuracy of the diagnosis of type 2 autoimmune pancreatitis.
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http://dx.doi.org/10.1186/s13256-024-04982-6 | DOI Listing |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660453 | PMC |
Cell Mol Life Sci
December 2024
Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
Cell metabolism is crucial for orchestrating the differentiation and function of regulatory T cells (Tregs). However, the underlying mechanism that coordinates cell metabolism to regulate Treg activity is not completely understood. As a pivotal molecule in lipid metabolism, the role of SHIP-1 in Tregs remains unknown.
View Article and Find Full Text PDFUnited European Gastroenterol J
December 2024
IRCCS San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan, Italy.
Autoimmune pancreatitis is an increasingly recognized inflammatory type of subacute pancreatitis; two subtypes of autoimmune pancreatitis have been identified so far: the "lymphoplasmacytic" type 1 variant and the "neutrophilic" type 2 variant. Type 1 autoimmune pancreatitis represents the most common manifestation of IgG4-related disease, a fibro-inflammatory disorder characterized by elevated IgG4 levels in the serum and affected tissues. Type 2 autoimmune pancreatitis is a pancreas-specific disorder that frequently occurs in the context of inflammatory bowel diseases.
View Article and Find Full Text PDFJ Diabetes Sci Technol
December 2024
Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Background: Type 1 diabetes (T1D) is characterized by the autoimmune destruction of pancreatic beta cells, leading to lifelong insulin dependence. Despite advancements in insulin therapies and glucose monitoring, maintaining optimal blood glucose control remains challenging with common issues like weight gain and glucose variability. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), approved for type 2 diabetes and obesity, are being explored off-label for T1D.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Department of Pathology, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka.
Introduction: Primary bone marrow diffuse large B-cell lymphoma is a rare clinical entity, and the "bone marrow-liver-spleen" type of diffuse large B-cell lymphoma is rarer, with only a few published cases in literature. Though bone marrow-liver-spleen-type diffuse large B-cell lymphoma has unique presentations such as fever, cytopenias, and hemophagocytic lymphohistiocytosis, no cases with cold autoimmune hemolytic anemia have been reported.
Case Presentation: A 39-year-old Sri Lankan woman, previously healthy, presented with shortness of breath, productive cough, and fever for 4 days.
BMJ Open Diabetes Res Care
December 2024
Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Gelderland, Netherlands.
Introduction: Maturity-onset diabetes of the young (MODY) and neonatal diabetes mellitus (NDM) are the most prevalent causes of monogenic diabetes. MODY is an autosomal dominant condition with onset in childhood and young adulthood, while NDM is defined with diabetes onset within 6 months of age and can be caused by dominant, recessive, X-linked genes or by chromosomal abnormalities. Here, we describe a rare case of monogenic diabetes in a patient who is homozygous for an gene variant.
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