Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Case Report Volume 7 Issue 6

Autoimmune Pancreatitis in a 9-Year-Old Boy

Sarah Saleh1, Houssein Chebbo1, Karam Karam2*, Sarah Jalloul2, Johny Salem3, George El Hashem4, Elias Fiani5 and Pierre Hani6

1Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
2Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
3Department of Internal Medicine, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
4Associate Professor of Clinical Medicine in Hematology and Oncology, Faculty of Medicine, Saint George University of Beirut
5Associate Professor, Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon

*Corresponding Author: Pierre Hani, Associate Professor, Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon

Received: May 10, 2024; Published: May 31, 2024

Abstract

Introduction: Autoimmune pancreatitis (AIP) is a rare and distinct form of chronic pancreatitis with autoimmune manifestations. The diagnosis of AIP is suggested by a combination of clinical features, imaging modalities of pancreatic parenchyma and ducts, and serology. We present the case of a pediatric male patient with recurrent bouts of painless jaundice.

Case: A 9-year-old male patient was admitted to the emergency department with painless jaundice and scleral icterus. Ct scan of the abdomen revealed diffuse enlargement of the pancreas with featureless borders and loss of definition of the pancreatic clefts, revealing a “sausage-like” appearance. Those findings are highly suggestive of Autoimmune Pancreatitis (AIP). Autoimmune serology revealed normal levels of immunoglobulin IgG4 and other immunologic markers. A trial of prednisone for six weeks was initiated and yielded a remarkable resolution of the patient's symptoms.

Discussion: The pathophysiology of autoimmune pancreatitis is not well understood in the pediatric age group. Adults usually experience painless obstructive jaundice and weight loss, while children are more likely to present with acute abdominal pain and obstructive jaundice, along with other findings like weight loss, fatigue, and vomiting. In our case, the patient presented an atypical presentation of pediatric AIP with a painless and obstructive pattern of jaundice similar to the adult presentation.

Conclusion: Autoimmune pancreatitis is a rare condition, predominantly seen in adults but has also been described in children. Clinicians should keep this disease on the differential in patients presenting with obstructive jaundice.

Keywords: Autoimmune Pancreatitis; Sausage Shape Pancreas; Corticosteroids

References

  1. Dite P., et al. “Autoimmune pancreatitis”. Best Practice and Research Clinical Gastroenterology1 (2008): 131-143.
  2. Khandelwal A., et al. “Autoimmune pancreatitis: an update”. Abdominal Radiology (NY)5 (2020): 1359-1370.
  3. Yoshida K., et al. “Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis”. Digestive Diseases and Sciences 7 (1995): 1561-1568.
  4. “Autoimmune pancreatitis classification, diagnosis, treatment and factors associated with disease reccurence”. Medicinos mokslai4 (2023).
  5. Scheers I., et al. “Autoimmune Pancreatitis in Children: Characteristic Features, Diagnosis, and Management”. American Journal of Gastroenterology10 (2017): 1604-1611.
  6. Nista EC., et al. “Autoimmune Pancreatitis: From Pathogenesis to Treatment”. International Journal of Molecular Sciences 20 (2022): 12667.
  7. Scheers I., et al. “Recommendations for Diagnosis and Management of Autoimmune Pancreatitis in Childhood: Consensus From INSPPIRE”. Journal of Pediatric Gastroenterology and Nutrition 2 (2018): 232-236.
  8. Chari ST., et al. “Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience”. Clinical Gastroenterology and Hepatology 8 (2006): 1010-1016; quiz 934.

Citation

Citation: Pierre Hani., et al. “Autoimmune Pancreatitis in a 9-Year-Old Boy". Acta Scientific Gastrointestinal Disorders 7.6 (2024): 18-21.

Copyright

Copyright: © 2024 Pierre Hani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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