A case report of autoimmune pancreatitis accompanied with rapidly developing hyperglycemia and hypertension in a chronic hemodialysis patient.
An 81-year-old man, with chronic renal failure due to chronic glomerulonephritis on maintenance hemodialysis (HD) for 4.5 years, was admitted to our hospital because of rapidly developing hyperglycemia and hypertension. He had been under good control on HD with no history of hyperglycemia. One month prior to admission he felt thirsty and generally fatigued, but did not inform medical staff of his symptoms. We diagnosed him as suffering from autoimmune pancreatitis (AIMP) associated with secondary diabetes mellitus, according to the typical feature of AIMP on endoscopic retrograde cholangiopancreatography and an elevated level of serum immunoglobulin G4 (IgG4). He was treated with insulin and a corticosteroid, following which, the diffuse narrowing of the main pancreatic duct improved and his serum IgG4 level reduced. AIMP is a rare but important complication in HD patients that requires prompt diagnosis and treatment; we are therefore reporting on a unique complication in a chronic HD patient.
Wada
Kentaro
K
Department of Internal Medicine, Division of Nephrology and Dialysis, Social Insurance Chuo General Hospital, Shinjuku-Ku, Tokyo, Japan. kyw620@hotmail.co.jp
Shinoda
Toshio
T
Yoshimoto
Hiroshi
H
D000369:Aged, 80 and over; D001327:Autoimmune Diseases; D002760:Cholangiopancreatography, Endoscopic Retrograde; D048909:Diabetes Complications; D005921:Glomerulonephritis / Q000150:complications; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia / Q000628:therapy*; D006973:Hypertension / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007074:Immunoglobulin G / Q000097:blood; D007328:Insulin / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008297:Male; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D006435:Renal Dialysis
D005938:Glucocorticoids; D007004:Hypoglycemic Agents; D007074:Immunoglobulin G; D007328:Insulin; D011239:Prednisolone