Idiopathic duct-centric pancreatitis (IDCP) with immunological studies.

A 65-year-old woman with elevated serum levels of pancreatic enzymes was referred to our hospital for further examinations. Abdominal US and contrast-enhanced CT demonstrated swelling of the pancreas body and tail. MRCP and ERCP revealed abrupt ending of the MPD in the pancreas body. Under the suspicion of malignancy, distal pancreatectomy and splenectomy were performed. The histopathological findings showed idiopathic duct-centric pancreatitis (IDCP) with granulocytic epithelial lesions (GEL). As most cases of Japanese autoimmune pancreatitis (AIP) are lymphoplasmacytic sclerosing pancreatitis (LPSP), the present case seems to be helpful to clarify the clinical findings of IDCP in Japan.

[1]  K. Uchida,et al.  Analysis of regulatory T cells and IgG4-positive plasma cells among patients of IgG4-related sclerosing cholangitis and autoimmune liver diseases , 2010, Journal of Gastroenterology.

[2]  M. Falconi,et al.  Autoimmune Pancreatitis: Differences Between the Focal and Diffuse Forms in 87 Patients , 2009, The American Journal of Gastroenterology.

[3]  K. Uchida,et al.  Circulating Naïve and CD4+CD25high Regulatory T Cells in Patients With Autoimmune Pancreatitis , 2008, Pancreas.

[4]  K. Uchida,et al.  How to diagnose autoimmune pancreatitis by the revised Japanese clinical criteria , 2007, Journal of Gastroenterology.

[5]  T. Kamisawa,et al.  Autoimmune Pancreatitis in Young Patients , 2006, Journal of clinical gastroenterology.

[6]  T. Shimosegawa,et al.  Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal , 2006, Journal of Gastroenterology.

[7]  T. Kamisawa.  Clinical subtypes of autoimmune pancreatitis. , 2005, Internal medicine.

[8]  G. Zamboni,et al.  Histopathological features of diagnostic and clinical relevance in autoimmune pancreatitis: a study on 53 resection specimens and 9 biopsy specimens , 2004, Virchows Archiv.

[9]  T. Smyrk,et al.  Idiopathic Chronic Pancreatitis With Periductal Lymphoplasmacytic Infiltration: Clinicopathologic Features of 35 Cases , 2003, The American journal of surgical pathology.

[10]  M. Farnell,et al.  Idiopathic tumefactive chronic pancreatitis: clinical profile, histology, and natural history after resection. , 2003, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[11]  T. Chiba,et al.  Clinical analysis of autoimmune-related pancreatitis , 2000, American Journal of Gastroenterology.

[12]  T. Chiba,et al.  Autoimmune-related pancreatitis is associated with autoantibodies and a Th1/Th2-type cellular immune response. , 2000, Gastroenterology.

[13]  M. Stolte,et al.  Non-alcoholic duct destructive chronic pancreatitis , 1997, Gut.

[14]  K. Shiratori,et al.  Chronic pancreatitis caused by an autoimmune abnormality , 1995, Digestive Diseases and Sciences.

[15]  J. May,et al.  HEART FAILURE DUE TO AN ARTERIOVENOUS FISTULA FOR HÆMODIALYSIS , 1973, The Medical journal of Australia.

[16]  H. Sarles,et al.  Chronic inflammatory sclerosis of the pancreas—An autonomous pancreatic disease? , 1961, The American Journal of Digestive Diseases.

[17]  T. Smyrk,et al.  IgG4-positive plasma cell infiltration in the diagnosis of autoimmune pancreatitis , 2007, Modern Pathology.

[18]  Kazuichi Okazaki,et al.  Autoimmune pancreatitis. , 2005, Internal medicine.

[19]  T. Yoshikawa,et al.  [Autoimmune disease]. , 2005, Nihon rinsho. Japanese journal of clinical medicine.

[20]  濱野 英明.  High serum IgG4 concentrations in patients with sclerosing pancreatitis , 2002 .

[21]  Kenji Kawaguchi,et al.  Lymphoplasmacytic sclerosing pancreatitis with cholangitis: a variant of primary sclerosing cholangitis extensively involving pancreas. , 1991, Human pathology.