November 12, 2014
Notes: Han, Dong Hee
Moh, In Ho
Ihm, Sung Hee
Yoo, Hyung Joon
Korean J Intern Med. 2013 Sep;28(5):609-13. doi: 10.3904/kjim.2013.28.5.609. Epub 2013 Aug 14.
Author Address: Division of Endocrinology, Department of Internal Medicine, Hallym University College of Medicine, Hwaseong, Korea.
Reference Type: Journal Article
Record Number: 4968Author: Hanna, M. S., Terlevich, A., Przemioslo, R. and Marden, P.
Title: Autoimmune pancreatitis complicated by spontaneous subcapsular splenic haemorrhage
Short Title: Autoimmune pancreatitis complicated by spontaneous subcapsular splenic haemorrhage
Alternate Journal: JOP : Journal of the pancreas
ISSN: 1590-8577 (Electronic)
Accession Number: 24018595
Autoimmune Diseases/complications/*diagnosis/drug therapy
Tomography, X-Ray Computed
Abstract: CONTEXT: Autoimmune pancreatitis is a rare but increasingly recognised condition with unique clinical, immunological and histological features. We report the first case of autoimmune pancreatitis associated with spontaneous splenic haemorrhage. CASE REPORT: A 75-year-old man presented with severe epigastric pain radiating to the back associated with nausea and vomiting. A CT-scan of his abdomen showed a large pseudocyst within the pancreatic tail as well as a subcapsular splenic haemorrhage. His IgG4 levels were elevated and clinical history and investigations were consistent with severe acute pancreatitis, but were negative for other known causes of pancreatic disease. The patient was started on steroid therapy and improved dramatically clinically, immunologically and radiologically thus confirming the diagnosis of autoimmune pancreatitis. His splenic haemorrhage was managed conservatively in view of his haemodynamic stablity and eventually self-resolved. CONCLUSION: Autoimmune pancreatitis should not be overlooked in cases of acute pancreatitis without other obvious etiology. Furthermore, superimposed splenic haemorrhage is a rare but important complication of autoimmune pancreatitis.