The investigation of clinical and radiological findings of igG4-related autoimmune pancreatitis

Abstract

This study aims to investigate the clinical and radiological findings of IgG4-related autoimmune pancreatitis diagnosed in our clinic. The data of patient files diagnosed as IgG4-related autoimmune pancreatitis in our hospital between March 2015 and February 2020 were reviewed retrospectively. 17 cases were included in the study. 10 of the cases were male (59 %) and 7 were female (41 %). Their ages ranged between 47 and 72, and the mean age was 61 ± 4.5. Clinical and laboratory findings with radiological imaging findings of the cases were investigated. The most common symptoms seen during admission to the clinic were obstructive jaundice (65 %), weight loss (53 %) and diabetes mellitus (29 %) that occurred recently. In laboratory examination, there was an increase in CEA and CA 19-9 in 9 patients (53 %). Increased IgG4 was measured in 11 patients (65 %). Some of the patients were accompanied by retroperitoneal fibrosis (3 cases), thyroiditis (2 cases), cholangitis (2 cases) and cholecystitis (1 case). In computed tomography (CT) and Magnetic Resonance Imaging (MRI) examination, diffuse increase in the size of the pancreas was observed in 14 cases (82 %). The focal increased size was most frequently observed in the pancreatic head. Recurrence developed in 5 of the patients (29 %) who received steroid treatment. As a Conclusion, autoimmune pancreatitis is a rare form of chronic pancreatitis that occurs with autoimmune mechanisms. It can be confused clinically with pancreatic cancer. Other extrapancreatic pathologies associated with IgG4 may accompany. Although IgG4 is helpful in diagnosis, the positive predictive value is low. The diagnosis of the disease is very important in terms of treatment. Clinical and radiological findings have an important role in the diagnosis of the disease.