Concomitant Autoimmune Pancreatitis Type 2 and Colitis Ulcerosa in a 10 Years-Old Girl
Stefan Bittmann *
Department of Pediatrics, Ped Mind Institute (PMI), Department of Pediatrics, Hindenburgring 4, D-48599-Gronau, Germany and Shangluo Vocational and Technical College, Shangluo-726000, Shaanxi, China.
Elisabeth Luchter
Department of Pediatrics, Ped Mind Institute (PMI), Department of Pediatrics, Hindenburgring 4, D-48599-Gronau, Germany.
Elena Moschüring-Alieva
Department of Pediatrics, Ped Mind Institute (PMI), Department of Pediatrics, Hindenburgring 4, D-48599-Gronau, Germany.
*Author to whom correspondence should be addressed.
Abstract
Autoimmune pancreatitis (AIP) has gained significant attention in recent years, with a notable increase in diagnoses due to the diagnostic utility of immunoglobulin G4 (IgG4). Despite the well-known IgG4-related type 1 AIP, a less recognized subtype known as type 2 AIP exists, which is distinct from type 1 AIP and not associated with IgG4. Type 2 AIP presents similar clinical symptoms and imaging findings as type 1 AIP, making its diagnosis challenging without specific serum markers. Tissue confirmation of neutrophilic injury to the pancreatic ducts, known as a granulocytic epithelial lesion, is crucial for diagnosing type 2 AIP. Some cases of type 2 AIP are linked to inflammatory bowel disease, particularly ulcerative colitis, but the exact relationship between the two conditions remains unclear. Questions remain regarding the pathophysiology of type 2 AIP, the possibility of similar granulocytic injuries in other organs, and the characteristics of pediatric cases. In this case report we present a concomitant autoimmune pancreatitis type 2 and colitis ulcerosa in a 10 years-old girl. The patients follow-up showed amelioration of the clinical symptoms due to the present medication.
Keywords: Autoimmune, child, colitis, pancreatitis, treatment, morphological changes