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Thrombotic thrombocytopenic purpura (TTP) leading to pseudotumour's autoimmune pancreatitis (AIP): a case report
Clovis Foguem1, Arnaud Boruchowicz, Philippe Cuingnet
1Centre for Food and Taste Sciences (CSGA), UMR 6265 CNRS (National Centre for Scientific Research), UMR 1324 INRA, University of Burgundy, 9 E Boulevard Jeanne d'Arc, 21000 Dijon, France. cfoguem@yahoo.fr
Introduction:
Autoimmune pancreatitis is an idiopathic inflammatory disease that produces pancreatic masses and ductal strictures. This benign disease can be associated with extrapancreatic manifestations including cholangitis, sialadenitis, inflammatory bowel disease or retroperitoneal fibrosis, mediastinal adenopathy, interstitial nephritis mainly due to immunoglobulin G4 (Ig G4), and occasional association with other auto-immune diseases.
Observation:
We report a 57-year-old woman who developed thrombotic thrombocytopenic purpura (TTP) and pseudo-tumour's seronegative autoimmune pancreatitis (AIP) type 1. The patient was initially treated with pulse corticosteroids and plasmapheresis; afterwards two cures of i.v. Vincristin with inadequate response and subsequently with four weekly pulses dose of i.v. Rituximab, leading to full remission.
Conclusion:
This case represents the first report of TTP associated to pseudo-tumour's seronegative AIP type 1 successfully treat by Rituximab.
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Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
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