title: Type 2 autoimmune pancreatitis: case report of a 9-year-old female and a review of the literature.
abstract: We report a case of autoimmune pancreatitis in a 9-year-old female who presented with persistent epigastric pain for 3 weeks. Magnetic resonance cholangiopancreatography (MRCP) showed both intrahepatic and extrahepatic biliary ductal dilatation. The common bile duct, along with the pancreatic duct, was noted to be dilated. Labs showed normal IgG and IgG4 levels and negative for autoimmune antibodies. Endoscopic ultrasound revealed the pancreatic head to be enlarged and surrounded by hypoechoic and lobulated lymph nodes. Biopsy of the pancreatic head showed chronic mildly active inflammation with fibrosis, acinar atrophy, and lymphocytic infiltrate. A diagnosis of autoimmune pancreatitis (AIP) was made, and she was treated with prednisone. The patient's symptoms improved quickly, and follow-up MRCP showed resolution of inflammatory changes and intrahepatic and pancreatic ductal dilatation.
authors.affiliation: Department of Internal Medicine, Winthrop University Hospital, 259 First St, Mineola, NY, 11501, USA. zpatel1988@gmail.com.
authors.forename: Zinal
authors.initials: Z
authors.lastname: Patel
authors.affiliation: Department of Internal Medicine, Winthrop University Hospital, 259 First St, Mineola, NY, 11501, USA.
authors.forename: Suril
authors.initials: S
authors.lastname: Patel
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Winthrop University Hospital, 222 Station Plaza N, Suite # 429, Mineola, NY, 11501, USA.
authors.forename: James
authors.initials: J
authors.lastname: Grendell
authors.affiliation: Division of Pediatric Endoscopy, Winthrop University Hospital, 120 Mineola Blvd, Suite # 210, Mineola, NY, 11501, USA.
authors.forename: Tuvia
authors.initials: T
authors.lastname: Marciano
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000188:drug therapy; D002648:Child; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008775:Methylprednisolone / Q000627:therapeutic use; D010195:Pancreatitis / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D007074:Immunoglobulin G; D008775:Methylprednisolone
keywords: Autoimmune pancreatitis; Corticosteroids; Epigastric pain