A Diagnostic Conundrum: A Case of Pediatric Autoimmune Pancreatitis.

Naseem Ravanbakhsh, Nick Shillingford, Travis L Piester
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Abstract

Autoimmune pancreatitis (AIP) is rare cause of abdominal pain in children who often present with obstructive jaundice, mimicking malignancy. An investigation of clinical symptoms, serology, imaging, and histopathology is necessary for diagnosis. We report a 10-year-old female presenting with abdominal pain and jaundice, ultimately found to have AIP after confirmation with tissue pathology. Our patient's prompt response to corticosteroid initiation is characteristic of this disease state. AIP has 2 subtypes, the second of which is more frequently found in children. Our patient's pathology did not fit perfectly with either subtype, but had features found in each one. While diagnostic criteria for AIP have not established in pediatrics, our case highlights the combination of clinical symptoms, imaging, and histopathology that children classically present with. While rare, the diagnosis of AIP is associated with comorbidities and must be considered in any child presenting with a pancreatic mass or biliary stricture.

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诊断难题:儿童自身免疫性胰腺炎1例
自身免疫性胰腺炎(AIP)是儿童腹痛的罕见原因,通常表现为阻塞性黄疸,类似恶性肿瘤。临床症状、血清学、影像学和组织病理学的调查是诊断所必需的。我们报告一名10岁的女性,以腹痛和黄疸为表现,经组织病理证实后,最终发现患有AIP。我们的病人对皮质类固醇的迅速反应是这种疾病状态的特征。AIP有两种亚型,其中第二种更常见于儿童。我们的病人的病理并不完全符合这两种亚型,但在每一种亚型中都有发现的特征。虽然儿科尚未建立AIP的诊断标准,但本病例强调了儿童典型表现的临床症状、影像学和组织病理学的结合。虽然罕见,但AIP的诊断与合并症有关,在任何出现胰腺肿块或胆道狭窄的儿童中都必须考虑。
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