Résumé
La pancréatite chronique autoimmune (PAI) est définie par un ensemble de critères cliniques, morphologiques, sérologiques et parfois histologiques.
La PAI peut prendre 2 formes: une forme diffuse et une forme pseudo-tumorale qui peut être confondue avec une tumeur maligne.
La PAI peut être associée à d’autres maladies autoimmunes (connectivités, cirrhose biliaire primitive ou cholangite sclérosante).
A ce propos, nous rapportons le cas d’un homme de 49 ans qui présente une PAI avec aspect initial pseudo-tumoral de la tête du pancréas ayant motivé une double dérivation bilio-digestive en 1995; celle-ci s’est compliquée de poussée aiguë avec développement de pseudokystes et d’une insuffisance pancréatique exocrine et endocrine associée à une cholangite sclérosante primitive avec lésions intra-et extrahépatiques diffuses sans maladie inflammatoire chronique de l’intestin ni présence d’auto-anticorps.
Cette observation est particulière par le caractère relativement sévère de la pancréatopathie avec notamment formation de pseudokystes qui sont exceptionnellement décrits dans la littérature.
Summary
The autoimmune pancreatitis is defined by a group of clinical, morphological, serological and sometimes histological criteria. The autoimmune pancreatitis can take 2 forms: a diffuse form and a pseudotumoral form which can be mistaken for a malignant tumor. The autoimmune pancreatitis can be associated with some autoimmune diseases (connectivities, primary biliary cirrhosis, primary sclerosing cholangitis).
In this view, we report the case of a 49-year old man suffering from autoimmune pancreatitis with initial pseudotumoral aspect of the pancreas head with a double biliodigestive derivation in 1995;it was complicated with acute pancreatitis, development of pseudo cysts and exocrine and endocrine pancreatic failure associated with a primary sclerosing cholangitis with intra and extrahepatic lesions without chronic inflammatory bowel disease or presence of autoantibodies. This observation is particular by the relatively severe character of the pancreatitis with development of the pseudocysts which are very exceptionally described in literature.
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Kabbaj, N., Errabih, I., Benaddi, L. et al. Pancréatite chronique autoimmune: une réalité nosologique — étude d’une observation l’associant à une cholangite sclérosante primitive. Acta Endosc 35, 785–791 (2005). https://doi.org/10.1007/BF03003349
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DOI: https://doi.org/10.1007/BF03003349