Atteintes extrapancréatiques au cours de la pancréatite auto-immune: particularités et apport diagnostique

摘要

Autoimmune pancreatitis is a rare entity. It represents 2 to 5% of chronic pancreatitis. With clinical, biological, and radiological particularities, extra pancreatic features of autoimmune pancreatitis have a great value for diagnosis. Our study concerns 3 cases of autoimmune panreatitis. We will study the extrapancreatic features particularities and their diagnosic value. We report 3 cases (two men and a woman 55, 28 and 24 years-old) with autoimmune pancreatitis with jaundice or epigastrium pain, synchronous and metachronous extrapancreatic features. In 2 cases, these extra-pancreatic features included cholangitis with renal atrophy and retroperitoneal fibrosis in one case. In the last case, we found Crohn’s disease and Gougerot-Sjogren disease. IGG4 level was high in the three cases. The diagnosis was made radiologically (CT scan, MRI) in two cases and histologically after duodenopanreatectomy in one case. Corticoid therapy had constituted a diagnosis and therapeutic test in two cases and treatment for extra-pancreatic features in one case. The presence of synchronous or metachronous inflammatory lesions of the biliary tract, kidney, intestine or other during the auto-immune pancreatitis can guide the diagnosis of this rare and often misunderstood disease. Their knowledge can save the patient a surgical procedure allowing medical treatment with corticosteroids.