Journal of Gastroenterology

, Volume 40, Issue 7, pp 761–766

Corticosteroid-responsive pancreatic cyst found in autoimmune pancreatitis

  • Takashi Muraki
  • Hideaki Hamano
  • Yasuhide Ochi
  • Norikazu Arakura
  • Mari Takayama
  • Kenichi Komatsu
  • Yuichi Komiyama
  • Shigeyuki Kawa
  • Takeshi Uehara
  • Kendo Kiyosawa
Case report

DOI: 10.1007/s00535-005-1622-z

Cite this article as:
Muraki, T., Hamano, H., Ochi, Y. et al. J Gastroenterol (2005) 40: 761. doi:10.1007/s00535-005-1622-z

Abstract

There have been only a few reports of autoimmune pancreatitis complicated with pancreatic cyst and such cysts are rare, probably due to the absence of severe tissue necrosis and/or lack of stasis of the pancreatic juice in this condition. However, during a follow-up of 48 patients with this disease, we found 3 patients with pancreatic cysts, and this enabled us to evaluate their clinicopathological findings. Between September 1994 and July 2003, we treated and followed 48 patients with autoimmune pancreatitis, and found 3 patients with pancreatic cyst formation that was responsive to corticosteroid therapy. All of the patients with cysts had high serum IgG4 concentrations. After corticosteroid therapy, rapid resolution of the pancreatic cysts was observed. Immunostaining with goat polyclonal antibody for each IgG subclass showed severe infiltration of IgG4-positive plasma cells in the cyst wall in one patient. The high serum IgG4 concentration and favorable response to corticosteroid therapy suggests that a highly active state of the inflammatory process is closely associated with cyst formation, and that a corticosteroid-responsive pancreatic cyst is a characteristic feature of autoimmune pancreatitis.

Key words

pancreatic cystautoimmune pancreatitiscorticosteroid

Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Takashi Muraki
    • 1
  • Hideaki Hamano
    • 1
  • Yasuhide Ochi
    • 1
  • Norikazu Arakura
    • 1
  • Mari Takayama
    • 1
  • Kenichi Komatsu
    • 1
  • Yuichi Komiyama
    • 1
  • Shigeyuki Kawa
    • 1
  • Takeshi Uehara
    • 2
  • Kendo Kiyosawa
    • 1
  1. 1.Department of Medicine, GastroenterologyShinshu University School of MedicineMatsumotoJapan
  2. 2.Department of Laboratory MedicineShinshu University School of MedicineMatsumotoJapan