Autoimmune pancreatitis with extreme elevation of DUPAN-2.
An 80-year-old woman was admitted to our hospital with complaints of jaundice and liver dysfunction. She was found to have a high titer of serum IgG4, positive rheumatoid factor and marked elevation of DUPAN-2 (11,148 U/ml). Computed tomography showed swelling of the pancreas, and endoscopic retrograde cholangiopancreatography revealed diffuse irregular narrowing of the main pancreatic duct, which are typical findings of autoimmune pancreatitis. There was no evidence of malignancy. Administration of 30 mg/day of prednisolone was started. Computed tomography showed significant regression in the size of the pancreas, and the stenosis of the main pancreatic duct was improved on ERCP. The serum level of DUPAN-2 was also markedly decreased after the treatment.
Mishima
Shiho
S
Department of Internal Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan.
Mizuta
Yohei
Y
Yamao
Takuji
T
Yamakawa
Masaki
M
Akazawa
Yuko
Y
Mishima
Ryosuke
R
Ohba
Kazuo
K
Masuda
Jun-ich
JI
Ohnita
Ken
K
Isomoto
Hajime
H
Shikuwa
Saburo
S
Omagari
Katsuhisa
K
Kohno
Shigeru
S
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D001327:Autoimmune Diseases / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010186:Pancreatic Function Tests; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D010195:Pancreatitis / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000951:Antigens, Neoplasm; D015415:Biomarkers; C042317:DU-PAN-2 antigen, human