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Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2021, Number 3

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Alerg Asma Inmunol Pediatr 2021; 30 (3)

Incidence of autoimmune pancreatitis in patients diagnosed with idiopathic chronic pancreatitis

Reyes AJ, Zárate MF, Cervantes BR, Cadena LJ, Toro ME, Ignorosa AK, Montijo BE, Loredo MA, Ramírez MJ

Language: Spanish
References: 16
Page: 99-103
PDF size: 135.53 Kb.


ABSTRACT

Introduction: Autoimmune pancreatitis is a distinct and rare form of pancreatitis in children with a poorly understood pathophysiology, only 4% of children with idiopathic chronic pancreatitis are at risk of developing autoimmune pancreatitis. Objetivos: To describe the clinical, biochemical, radiological, endoscopic, and histological characteristics in children with a diagnosis of chronic idiopathic pancreatitis and report the experience in serum IgG4 measurement. Material and methods: Observational, descriptive, cross-sectional and retrospective study of children with chronic idiopathic pancreatitis who were diagnosed at the National Institute of Pediatrics from January 01, 2001 to December 31, 2010, the clinical records of children with this diagnosis were reviewed and performed serum IgG4 measurement. Results: Four children were found with a diagnosis of chronic idiopathic pancreatitis, the predominant symptoms were abdominal pain followed by nausea and vomiting. The main radiological findings reported were enlargement of the pancreatic gland, peri-pancreatic fat hyperdensity, distended gallbladder, and dilation of the main pancreatic duct. The measurement of IgG4 in all cases less than 135 mg/dL. Conclusions: Autoimmune pancreatitis (AIP) is different in children compared to adults. The determination of serum IgG4 in adulthood has high diagnostic value and in pediatric age, elevated IgG4 can only occur in 22% of cases. As in adults, it strongly supports the diagnosis of AIP when the determination is > 135 mg/dL, however, normal figures do not rule out AIP. It is necessary to report the clinical, biochemical, radiological, endoscopic and histopathological findings in childhood to facilitate the stratification of these patients for future research studies.


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