Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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A Case of Autoimmune Chronic Pancreatitis in a Child

자가면역성 만성 췌장염으로 진단된 소아 1예

  • Choi, In-Young (Department of Pediatrics, Presbyterian Medical Center) ;
  • Jin, So-Hee (Department of Pediatrics, Presbyterian Medical Center) ;
  • Choi, Kyung-Dan (Department of Pediatrics, Presbyterian Medical Center) ;
  • Kim, Kyung-Mo (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine)
  • 최인영 (전주 예수병원 소아과) ;
  • 진소희 (전주 예수병원 소아과) ;
  • 최경단 (전주 예수병원 소아과) ;
  • 김경모 (울산대학교 의과대학 서울아산병원 소아과학교실)
  • Received : 2007.07.30
  • Accepted : 2007.08.30
  • Published : 2007.09.30
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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.

저자들은 자가면역 질환이 없는 건강한 소아가 황달을 동반하지 않는 급성 복통으로 내원하여 혈청 amylase, lipase의 지속적인 상승과 혈청 IgG 증가, 자가항체(ANA, ANCA) 양성, 방사선 영상에서 췌장 실질종대와 췌장 미부 주췌관의 불규칙적 협착으로 자가면역성 만성 췌장염으로 진단받고 스테로이드와 azathioprine을 경구 복용하였으며 미부 주췌관 협착의 풍선확장술을 시행하고 회복된 1예를 경험하였기에 보고하는 바이다.

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