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Published on: December 15, 2011
A case of synchronous IgG4-associated pleuritis and type 1 autoimmune pancreatitis
Jun Noda1, Yuichi Takano2, Masataka Yamawaki2
1Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Kanagawa, 227-8501, Japan. nodaji0317@med.showa-u.ac.jp.
Abstract:
A 50-year-old man presented to the emergency department with left chest pain, epigastralgia, and low-grade fever for several days. A CT scan showed left pleural effusion, ground-glass opacities in the lower lobes of both lungs, and a capsule-like rim in the pancreas. ERCP showed narrowing of the main pancreatic duct. EUS-FNA was performed, but pathological findings showed no IgG4-positive cells. A thoracoscopic biopsy was performed, and pathological findings showed many IgG4-positive cells. A diagnosis of autoimmune pancreatitis and IgG4-associated pleurisy was made according to international diagnostic criteria. After that, oral steroid therapy was started, and left pleural effusion and pancreatic enlargement improved.
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