Clinical and sonographic features of automimune pancreatitis / 中华医学超声杂志（电子版）

ABSTRACT

Objective To investigate the clinical and sonographic features of automimune pancreatitis (AIP). Methods We analyzed the clinical and sonographic features of 28 patients who were diagnosed as AIP in Peking Union Medical College Hospital from January 2013 to December 2014. Results Clinical features the initial manifestation was obstructive jaundice in 19 cases. Fourteen cases were accompanied with type 2 diabetes. Eight cases were accompanied with IgG4-related diseases in other organs. Twenty-five cases had elevated IgG4 serum levels. Six cases had positive antinuclear antibodies. Eighteen cases had steroids therapy, 15 of whom had a good response to steroids, 3 of whom had a poor response. The ultrasonographic features were as follows(1) Among 18 cases of diffuse type of AIP were as follows16 cases had a diffused,“sausage-like”enlarged pancreas. Fifteen cases had diffusely decreased echogenicity, with fibrous hyperechoic spots. (2) Ten cases of local type of AIP were as followsthe pancreas had local enlarged segment or a“tumor”was formed, but the echogenicity of tumor was similar to the rest of the pancreas. Six cases had irregular shape. (3) Seven cases had ill-defined margin. Six cases had a little blood flow. Two cases had no blood flow. Seven cases had upstream dilation of the main pancreatic duct. Nineteen cases had dilation of the proximal section of the common bile duct. Twelve cases had dilation of the intrahepatic bile duct. Conclusions AIP have some sonographic features. Patients are often older, having abdominal pain, obstructive jaundice, and diffused or local enlargement of pancreas. Combining with the clinical data and laboratory examination may help the diagnosis of AIP.