Autoimmune pancreatitis. Case report.

Abstract

This is a 41-year-old male patient who begins current illness on October 25, 2021 when he presents hypocholia without coluria, pasty stools, additive arthralgias, abdominal pain in the mesogastrium of a dull nature, moderate to strong intensity, irradiated to Right hypochondrium, ipsilateral lumbar and scapular region, goes to the emergency, to the physical examination vital signs within normality, soft, depressed abdomen, painful on palpation in the hypogastrium and mesogastrium, blood tests are performed which report alteration of liver function tests and lipase 1,222 IU / L, abdominal ultrasound showed a space-occupying lesion in the uncinate process of the pancreas with a hypoechoic pattern, non-contrasting abdominal CT, peripancreatic edema, increased diffuse configuration with microcalcifications in the head of the pancreas. Therefore, an endoscopic ultrasound was performed where a hypoechoic pancreas, short and long echogenic tracts, irregular borders, and microcalcifications were observed. Cholangioresonance was performed and it was ruled out. Due to the imaging findings of PAI, it was decided to request autoimmunity and IgG4 tests, it was decided to start steroid therapy with clinical and paraclinical improvement in 48 hours, so the patient was discharged. In his control, results of immunological tests were received and IgG4 being elevated, the patient remains asymptomatic with normalization of laboratory tests and with improvement of pancreatic morphological alterations in abdominal ultrasound.