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Type 2 Autoimmune Pancreatitis with Crohn's Disease
Yoon Suk Lee1, Nam-Hoon Kim1, Jun Hyuk Son1
1Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
Internal Medicine (Tokyo, Japan)
|March 13, 2018
Summary
Autoimmune pancreatitis (AIP) is a rare condition. This study reports a unique case of type 2 AIP co-occurring with Crohn's disease (CD) in an Asian patient, diagnosed via EUS-guided FNA.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Autoimmune pancreatitis (AIP) is a distinct inflammatory pancreatic condition.
- AIP is classified into type 1 and type 2 based on distinct clinicopathological features.
- Accurate histological evaluation is crucial for AIP diagnosis, typically requiring surgical resection or core biopsy specimens.
Observation:
- The simultaneous occurrence of type 2 AIP and Crohn's disease (CD) is exceptionally rare, particularly in Asian populations.
- Endoscopic ultrasonography (EUS) guided fine needle aspiration (FNA) has shown promise for histological evaluation in AIP.
- This case highlights a rare co-presentation of two distinct immune-mediated conditions.
Findings:
- A type 2 autoimmune pancreatitis (AIP) with co-existing Crohn's disease (CD) was diagnosed.
- EUS-guided fine needle aspiration (FNA) using a 22-gauge needle proved effective for obtaining diagnostic histological specimens.
- This diagnosis was achieved despite the rarity of this specific co-occurrence.
Implications:
- EUS-guided FNA can be a valuable tool for diagnosing type 2 AIP, even in rare co-presentations.
- This case expands the understanding of AIP and its potential associations with other immune-mediated diseases like CD.
- Further research may elucidate sharedPathogenic mechanisms or diagnostic approaches for such rare conditions.