Open AccessRare type of pancreatitis as the first presentation of anti-neutrophil cytoplasmic antibody-related vasculitis
Author(s) -
Tomoya Iida,
Takeya Adachi,
Tetsuya Tabeya,
Suguru Nakagaki,
Takashi Yabana,
Akira Gotō,
Yoshihiro Kondo,
Kiyoshi Kasai
Publication year - 2016
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v22.i7.2383
Subject(s) - medicine , vasculitis , pancreatitis , pathology , autoimmune pancreatitis , microscopic polyangiitis , pancreas , biopsy , endoscopic ultrasound , gastroenterology , radiology , disease
A pancreatic tumor was suspected on the abdominal ultrasound of a 72-year-old man. Abdominal computed tomography showed pancreatic enlargement as well as a diffuse, poorly enhanced area in the pancreas; endoscopic ultrasound-guided fine needle aspiration biopsy and endoscopic retrograde cholangiopancreatography failed to provide a definitive diagnosis. Based on the trend of improvement of the pancreatic enlargement, the treatment plan involved follow-up examinations. Later, he was hospitalized with an alveolar hemorrhage and rapidly progressive glomerulonephritis; he tested positive for myeloperoxidase-anti-neutrophil cytoplasmic antibody (ANCA) and was diagnosed with ANCA-related vasculitis, specifically microscopic polyangiitis. It appears that factors such as thrombus formation caused by the vasculitis in the early stages of ANCA-related vasculitis cause abnormal distribution of the pancreatic blood flow, resulting in non-uniform pancreatitis. Pancreatic lesions in ANCA-related vasculitis are very rare. Only a few cases have been reported previously. Therefore, we report our case and a review of the literature.