Two clinical cases of IgG4-associated pancreatitis in children
- Authors: Minina S.N.1, Kornienko E.A.1, Suspitsyn E.N.1, Imyanitov E.N.1
-
Affiliations:
- Saint Petersburg State Pediatric Medical University
- Issue: Vol 14, No 4 (2023)
- Pages: 113-123
- Section: Clinical observation
- URL: https://journals.rcsi.science/pediatr/article/view/232090
- DOI: https://doi.org/10.17816/PED144113-123
- ID: 232090
Cite item
Abstract
Autoimmune pancreatitis is a specific peculiar and rather new form of chronic pancreatitis (ChP) that has been intensively studied by pancreatology specialists of the whole world for the last years. Autoimmune pancreatitis does not have any individual specific clinical features. This condition was described for the first time in adults and it often mimics pancreas cancer. Autoimmune pancreatitis can involve some organs, synchronously or metachronously, and is rarely identified in children. Autoimmune pancreatitis is a systemic fiber-inflammatory condition with poorly understood pathophysiological mechanism, affecting different parts of the body. In case of the treatment absence the disease can lead to fibrosis and irreversible impairment of the organs. However, the combination of the findings of serologic, histologic, and instrumental methods of investigation characteristic for аutoimmune pancreatitis allows to identify its presence. IgG4-associated disorder has been mainly described in adults, therefore pediatricians usually do not know much about it. We underline the complexity of the diagnosis of autoimmune pancreatitis / IgG4-associated disorder, in children. The article presents two clinical cases of children diagnosed with autoimmune pancreatitis. Both children had the symptoms of abdominal pain and/or mechanical jaundice combined with focal pancreas enlargement, roughness of the basic pancreas duct and distal narrowing. According to our data, the diagnosis of autoimmune pancreatitis in children can be made on the basis of the combination of specific clinical symptoms at admission and various results of imaging. Both timely made diagnosis and administered treatment provide a favorable prognosis for further course of the disease and complication development.
Full Text
##article.viewOnOriginalSite##About the authors
Svetlana N. Minina
Saint Petersburg State Pediatric Medical University
Author for correspondence.
Email: s.drozdova@mail.ru
ORCID iD: 0009-0009-2163-4778
SPIN-code: 9129-4393
MD, PhD, Cand. Sci. (Med.), Associate Professor, Department of Children’s Diseases named after Professor I.M. Vorontsov Postgraduate and Additional Professional Education
Russian Federation, Saint PetersburgElena A. Kornienko
Saint Petersburg State Pediatric Medical University
Email: elenkornienk@yandex.ru
SPIN-code: 5120-9007
MD, PhD, Dr. Sci. (Med.), Professor, Department of Children’s Diseases named after Professor I.M. Vorontsov Postgraduate and Additional Professional Education
Russian Federation, Saint PetersburgEvgeny N. Suspitsyn
Saint Petersburg State Pediatric Medical University
Email: evgeny.suspitsin@gmail.com
ORCID iD: 0000-0001-9764-2090
SPIN-code: 2362-6304
MD, PhD, Cand. Sci. (Med.), Associate Professor, Department of Medical Genetics
Russian Federation, Saint PetersburgEvgeny N. Imyanitov
Saint Petersburg State Pediatric Medical University
Email: evgeny@imyanitov.spb.ru
ORCID iD: 0000-0003-4529-7891
SPIN-code: 1909-7323
MD, PhD, Dr. Sci. (Med.), Professor, Head, Department of Medical Genetics
Russian Federation, Saint PetersburgReferences
- Avanesyan RI, Avdeeva TG, Alekseeva EI, et al. Pediatriya: Natsional’noe rukovodstvo. In 2 vol. Moscow: GEOTAR-Media, 2009. (In Russ.)
- Alekseev VV, Alipov AN, Andreev VA. Meditsinskie laboratornye tekhnologii. In 2 vol. Vol. 2. Moscow: GEOTAR-Media, 2013. 792 p. (In Russ.)
- Okhlobystin AV. Autoimmune pancreatitis: new concepts of pathogenesis, diagnostics, and treatment. Russian Journal of Evidence-Based Gastroenterology. 2013;(1):2227. (In Russ.)
- Privorotsky VF, Luppova NE. Pancreatic type dysfunction of oddi sphincter in children. Pediatrician (St. Petersburg). 2016;7(3): 111–116. (In Russ.) doi: 10.17816/PED73111-116
- Yagupova AA, Kornienko EA, Loboda TB, Fadina SA. New diagnosis in pediatric practice: autoimmune pancreatitis. Pediatrician (St. Petersburg). 2013;4(4):48–55. (In Russ.) doi: 10.17816/PED4448-55
- Bolia R, Chong SY, Coleman L, et al. Autoimmune pancreatitis and IgG4 related disease in three children. ACG Case Rep J. 2016;3(4): e115. doi: 10.14309/crj.2016.88
- Chavhan GB, Babyn PS, Manson D, Vidarsson L. Pediatric MR cholangiopancreatography: principles, technique, and clinical applications. Radiographics. 2008;28(7):1951–1962. doi: 10.1148/rg.287085031
- Hamano H, Kawa S, Horiuchi A, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med. 2001;344(10):732–738. doi: 10.1056/NEJM200103083441005
- Hart PA, Kamisawa T, Brugge WR, et al. Long-term outcomes of autoimmune pancreatitis: a multicentre, international analysis. Gut. 2013;62(12):1771–1776. doi: 10.1136/gutjnl-2012-303617
- Hart PA, Zen Y, Chari ST. Recent advances in autoimmune pancreatitis. Gastroenterology. 2015;149(1):39–51. doi: 10.1053/j.gastro.2015.03.010
- Okazaki K, Kawa S, Kamisawa T, et al. Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis 2013 I. Concept and diagnosis of autoimmune pancreatitis. J Gastroenterol. 2014;49:567–588. doi: 10.1007/s00535-014-0942-2
- Refaat R, Harth M, Proschek P, et al. Autoimmune pancreatitis in an 11-year-old boy. Pediatr Radiol. 2009;39:389–392. doi: 10.1007/s00247-008-1132-2