ArticleInternal medicine (Tokyo, Japan)2026
Steroid-resistant Relapse of Autoimmune Pancreatitis with Marked Main Pancreatic Duct Dilatation Mimicking Multifocal Pancreatic Cancer.
Article in Internal medicine (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
A 67-year-old man with type 1 autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis experienced a relapse, while presenting with pancreatic head swelling and distal bile duct stenosis. Despite an increase in the prednisolone dosage (from 7.5 to 20 mg/day), the disease worsened. A significant dilatation of the main pancreatic duct (8 mm) and new stenosis of the pancreatic tail duct were observed. Malignancy was ruled out by repeated endoscopic ultrasound-guided fine-needle aspiration biopsies. A further escalation of the prednisolone dose to 40 mg/day led to clinical and radiological improvements. This case underscores the difficulty in distinguishing a steroid-resistant AIP relapse from pancreatic cancer, and the importance of ruling out malignancy before intensifying immunosuppressive therapy.
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