[Autoimmune pancreatitis (AIMP) - a clinical entity of its own?].
METHODS
A 34-year-old man with chronic inflammation of both tear glands for 10 years was admitted because of severe upper abdominal pain and jaundice.


METHODS
Transaminase and cholestasis parameters were raised, as were gamma-globulins on electrophoresis. Ultrasound revealed an echo-poor diffusely enlarged pancreas with hypervascularity on colour-Doppler. Endoscopic retrograde cholangiopancreatography (ERCP) indicated chronically changed pancreatic ducts of varying diameter and stenosis, as well as a filiform distal stenosis of the common bile duct. A pancreatic biopsy showed chronic sclerosing pancreatitis with broad periductal lymphocytic infiltration.


METHODS
ERCP and a guide-wire papillotomy were performed, followed by placement of a nasobiliary catheter. All findings markedly improved on oral prednisone.


CONCLUSIONS
This case supports the supposition that in idiopathic chronic pancreatitis autoimmune processes may be responsible for the changes in the pancreatic ducts. Immunosuppressive treatment is thus recommended in these cases.
Susset
M A
MA
Medizinische Klinik, Klinikum am Steinenberg Reutlingen, Germany. masusset@aol.com
Kunz
A
A
Sczepanski
B
B
Littmann
M
M
Blank
W
W
Braun
B
B
D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color
D000893:Anti-Inflammatory Agents; D011241:Prednisone