Autoimunitní pankreatitida v dětském věku

Abstract

Autoimmune pancreatitis is an idiopathic inflammatory disease of the pancreas that is rarely encountered even in paediatric patients. However, compared to adult patients, the clinical manifestation and course of the disease in children may differ. We present a case report of a 13-year-old boy admitted to our department with a history of abdominal pain, weight loss, vomiting, and sudden development of jaundice. Initial laboratory parameters showed signs of cholestasis, inflammatory parameters and pancreatic enzymes were in the normal range. ERCP examination demonstrated stenosis of the pancreatic part of ductus choledochus, sonography and MRCP examination showed lesion in the head of the pancreas and signs typical for autoimmune pancreatitis. Based on these findings, treatment with oral corticosteroids was started at an initial dose of 30 mg/day with a gradual reduction to the current maintenance dose, which is 5 mg of prednisone per day. The patient is currently in clinical remission; however, the exocrine dysfunction of the pancreas persists which we are solving by replacement of pancreatic enzymes. The aim of this paper is to present the basic features of the paediatric form of AIP and to point out the differences between AIP in children and adults. Keywords autoimmune pancreatitis, paediatric autoimmune pancreatitis, immunoglobulin G4, MRCP, steroids