title: Rare type of pancreatitis as the first presentation of anti-neutrophil cytoplasmic antibody-related vasculitis.
abstract: A pancreatic tumor was suspected on the abdominal ultrasound of a 72-year-old man. Abdominal computed tomography showed pancreatic enlargement as well as a diffuse, poorly enhanced area in the pancreas; endoscopic ultrasound-guided fine needle aspiration biopsy and endoscopic retrograde cholangiopancreatography failed to provide a definitive diagnosis. Based on the trend of improvement of the pancreatic enlargement, the treatment plan involved follow-up examinations. Later, he was hospitalized with an alveolar hemorrhage and rapidly progressive glomerulonephritis; he tested positive for myeloperoxidase-anti-neutrophil cytoplasmic antibody (ANCA) and was diagnosed with ANCA-related vasculitis, specifically microscopic polyangiitis. It appears that factors such as thrombus formation caused by the vasculitis in the early stages of ANCA-related vasculitis cause abnormal distribution of the pancreatic blood flow, resulting in non-uniform pancreatitis. Pancreatic lesions in ANCA-related vasculitis are very rare. Only a few cases have been reported previously. Therefore, we report our case and a review of the literature.
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Iida
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Takeya
authors.initials: T
authors.lastname: Adachi
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tabeya
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Nakagaki
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yabana
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Goto
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kondo
authors.affiliation: Tomoya Iida, Takeya Adachi, Suguru Nakagaki, Takashi Yabana, Akira Goto, Yoshihiro Kondo, Department of Gastroenterology, Otaru City General Hospital, Otaru, Hokkaido 047-8550, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kasai
mesh_terms: D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D018450:Disease Progression; D019160:Endosonography; D017809:Fatal Outcome; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D055953:Microscopic Polyangiitis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010179:Pancreas / Q000098:blood supply* / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D012039:Regional Blood Flow; D014057:Tomography, X-Ray Computed
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D015415:Biomarkers; D007166:Immunosuppressive Agents
keywords: Anti-neutrophil cytoplasmic; Antibodies; Microscopic polyangiitis; Pancreas; Pancreatitis; Vasculitis