Autoimmune pancreatitis with diabetes as the initial symptom: one case report and literature review

Abstract

Objective To summarize the clinical features of autoimmune pancreatitis (AIP) with diabetes as the initial symptom. Methods The clinical data of one case of AIP with diabetes as the initial symptom were analyzed. The 60-year-old male patient was diagnosed in March 2015 in the Department of Endocrinology in China-Japan Friendship Hospital. A follow-up study focused on the pancreatic endocrine and exocrine functions was conducted. Results Based on observation, the insulin secretion function in the patient was poor, whereas the glutamic acid decarboxylase antibody, insulin autoantibody and islet cell autoantibody were found negative. In addition, the lipase level was 801 U/L. The swelling of pancreas was found under magnetic resonance cholangiopancreatography. The patients was treated with prednisone for 4 months, the pancreatic swelling ameliorated and the serum lipase level restored to normal. However, the dosage of insulin treatment was unchanged during the prednisone treatment. Conclusions The IgG4 - related diseases should be paid more attention in suspected diabetes cases, especially in those with clinical characteristics between type 1 and type 2 diabetes, with negative autoantibody and without family history of diabetes, or those with other systematic symptoms. Key words: Diabetes mellitus; IgG4-related disease; Autoimmune pancreatitis