Autoimmune Pancreatitis with Extreme Elevation of DUPAN-2

Shiho Mishima; Yohei Mizuta; Takuji Yamao; Masaki Yamakawa; Yuko Akazawa; Ryosuke Mishima; Kazuo Ohba; Jun-ich Masuda; Ken Ohnita; Hajime Isomoto; Saburo Shikuwa; Katsuhisa Omagari; Shigeru Kohno

doi:10.2169/internalmedicine.46.6184

CASE REPORTS

Autoimmune Pancreatitis with Extreme Elevation of DUPAN-2

Shiho Mishima, Yohei Mizuta, Takuji Yamao, Masaki Yamakawa, Yuko Akazawa, Ryosuke Mishima, Kazuo Ohba, Jun-ich Masuda, Ken Ohnita, Hajime Isomoto, Saburo Shikuwa, Katsuhisa Omagari, Shigeru Kohno

Author information

Shiho Mishima
Department of Internal Medicine, Nagasaki Municipal Hospital
Second Department of Internal Medicine, Nagasaki University School of Medicine
Yohei Mizuta
Second Department of Internal Medicine, Nagasaki University School of Medicine
Takuji Yamao
Department of Internal Medicine, Nagasaki Municipal Hospital
Masaki Yamakawa
Department of Internal Medicine, Nagasaki Municipal Hospital
Yuko Akazawa
Second Department of Internal Medicine, Nagasaki University School of Medicine
Ryosuke Mishima
Second Department of Internal Medicine, Nagasaki University School of Medicine
Kazuo Ohba
Second Department of Internal Medicine, Nagasaki University School of Medicine
Jun-ich Masuda
Second Department of Internal Medicine, Nagasaki University School of Medicine
Ken Ohnita
Second Department of Internal Medicine, Nagasaki University School of Medicine
Hajime Isomoto
Second Department of Internal Medicine, Nagasaki University School of Medicine
Saburo Shikuwa
Second Department of Internal Medicine, Nagasaki University School of Medicine
Katsuhisa Omagari
Second Department of Internal Medicine, Nagasaki University School of Medicine
Shigeru Kohno
Second Department of Internal Medicine, Nagasaki University School of Medicine

Keywords: autoimmune pancreatitis, DUPAN-2, IgG4, steroid

JOURNAL OPEN ACCESS

2007 Volume 46 Issue 7 Pages 377-381

DOI https://doi.org/10.2169/internalmedicine.46.6184

Details

Abstract

An 80-year-old woman was admitted to our hospital with complaints of jaundice and liver dysfunction. She was found to have a high titer of serum IgG4, positive rheumatoid factor and marked elevation of DUPAN-2 (11,148 U/ml). Computed tomography showed swelling of the pancreas, and endoscopic retrograde cholangiopancreatography revealed diffuse irregular narrowing of the main pancreatic duct, which are typical findings of autoimmune pancreatitis. There was no evidence of malignancy. Administration of 30 mg/day of prednisolone was started. Computed tomography showed significant regression in the size of the pancreas, and the stenosis of the main pancreatic duct was improved on ERCP. The serum level of DUPAN-2 was also markedly decreased after the treatment.

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