자가면역성 만성 췌장염으로 진단된 소아 1예
A Case of A Case of Autoimmune Chronic Pancreatitis in a Child
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초록
저자들은 자가면역 질환이 없는 건강한 소아가 황달을 동반하지 않는 급성 복통으로 내원하여 혈청 amylase, lipase의 지속적인 상승과 혈청 IgG 증가, 자가 항체(ANA, ANCA) 양성, 방사선 영상에서 췌장 실질 종대와 췌장 미부 주췌관의 불규칙적 협착으로 자가면역성 만성 췌장염으로 진단받고 스테로이드와 azathioprine을 경구 복용하였으며 미부 주췌관 협착의 풍선 확장술을 시행하고 회복된 1예를 경험하였기에 보고하는 바이다.
Abstract
We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.
참고문헌 (34)
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- Tanaka S, "Corticosteroid-responsive diabetes mellitus associated with autoimmune pancreatitis", 356, pp.910~911 (2000)
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- Wakabayashi T, "Clinical study of chronic pancreatitis with focal irregular narrowing of the main pancreatic duct and mass formation: comparison with chronic pancreatitis showing diffuse irregular narrowing of the main pancreatic duct", 25, pp.283~289 (2002)
- Horiuchi A, "ERCP features in 27 patients with autoimmune pancreatitis", 55, pp.494~499 (2002)
- Kim KP, "Diagnostic criteria for autoimmune chronic pancreatitis revisited", 12, pp.2487~2496 (2006)
- Nishino T, "Long-term outcome of autoimmune pancreatitis after oral prednisolone therapy", 45, pp.497~501 (2006)
- Czakó L, "Autoimmune pancreatitis: functional and morphological recovery after steroid therapy", 12, pp.1810~1812 (2006)
- Sarles H, "Guien C. Chronic inflammatory sclerosis of the pancreas-an autonomous pancreatic disease", pp.688~98
- Yoshida K, "Chronic pancreatitis caused by an autoimmune abnormality: proposal of the concept of autoimmune pancreatitis", 40, pp.1561~1568 (1995)
- 김진영, "스테로이드 복용으로 호전된 자가면역성 만성 췌장염 1예", 39, pp.304~30 (2002)
- 이윤선, "폐쇄성 황달을 주소로 한 자가면역성 만성 췌장염 1예", 41, pp.234~238 (2003)
- 김규표, "자가면역성 만성 췌장염 17예의 임상상", 대한소화기학회지, 43(2), pp.112~119 (2004), 대한소화기학회
- Pearson RK, "Controversies in clinical pancreatology: autoimmune pancreatitis: does it exist?", 27, pp.1~13 (2003)
- Okazaki K, "Recent concept of autoimmune-related pancreatitis", 36, pp.293~302 (2001)
- Okazaki K, "Autoimmune related pancreatitis", 51, pp.1~4 (2002)
- Uchida K, "Clinical analysis of autoimmune- related pancreatitis", 95, pp.2788~2794 (2000)
- Kamisawa T, "Prognosis of autoimmune pancreatitis", 42(Suppl 18), pp.59~62 (2007)
- Tanaka S, "Corticosteroid-responsive diabetes mellitus associated with autoimmune pancreatitis", 356, pp.910~911 (2000)
- Okazaki K, "Autoimmune pancreatitis: etiology, pathogenesis, clinical findings and treatment. The Japanese experience", 6(Suppl 1), pp.89~96 (2005)
- Wakabayashi T, "Clinical study of chronic pancreatitis with focal irregular narrowing of the main pancreatic duct and mass formation: comparison with chronic pancreatitis showing diffuse irregular narrowing of the main pancreatic duct", 25, pp.283~289 (2002)
- Horiuchi A, "ERCP features in 27 patients with autoimmune pancreatitis", 55, pp.494~499 (2002)
- Kim KP, "Diagnostic criteria for autoimmune chronic pancreatitis revisited", 12, pp.2487~2496 (2006)
- Nishino T, "Long-term outcome of autoimmune pancreatitis after oral prednisolone therapy", 45, pp.497~501 (2006)
- Czak? L, "Autoimmune pancreatitis: functional and morphological recovery after steroid therapy", 12, pp.1810~1812 (2006)