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[Three cases of childhood-onset autoimmune pancreatitis]

Shinya Murata1, Atsushi Yoden, Tomoki Aomatsu

  • 1Department of Pediatrics, Hirakata City Hospital.

Nihon Shokakibyo Gakkai Zasshi = the Japanese Journal of Gastro-Enterology
|August 8, 2014
PubMed

Insights

Three boys with childhood autoimmune pancreatitis presented with abdominal pain and elevated pancreatic enzymes. This rare condition may be latent and associated with pediatric inflammatory bowel disease.

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Radiology

Background:

  • Autoimmune pancreatitis (AIP) is a rare pancreatic disease with limited reported cases in children.
  • Recognizing AIP in pediatric patients is crucial, especially those with undiagnosed or chronic abdominal symptoms.

Observation:

  • Three cases of childhood-onset AIP are presented, including two boys with ulcerative colitis and one previously healthy boy.
  • All patients exhibited abdominal pain and elevated pancreatic enzymes; imaging revealed pancreatic enlargement and main duct narrowing.
  • Elevated Immunoglobulin G4 (IgG4) levels were observed in only one of the three pediatric patients.

Findings:

  • Childhood-onset AIP can present with nonspecific abdominal pain and elevated pancreatic enzymes.
  • Radiological findings like pancreatic enlargement and ductal stenosis are key indicators in pediatric AIP.
  • Immunoglobulin G4 (IgG4) elevation is not consistently present in childhood AIP cases.

Implications:

  • Autoimmune pancreatitis may present latently in children with chronic or intermittent abdominal pain.
  • Pediatric inflammatory bowel disease (IBD) is a potential comorbidity requiring awareness for AIP.
  • Further case accumulation is essential to clarify the clinical features and diagnostic criteria for pediatric AIP.

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