自己免疫性膵炎、膵管狭細型慢性膵炎
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- 1. 成人における慢性膵炎の病因および発症機序etiology and pathogenesis of chronic pancreatitis in adults [show details]
… diffuse and irregular narrowing of the main pancreatic duct,… causes of chronic pancreatitis. Obstruction of the pancreatic duct from strictures secondary to trauma, pseudocysts, calcific stones, or tumors can lead to chronic pancreatitis .…
- 2. 膵管癒合不全:臨床症状および診断pancreas divisum clinical manifestations and diagnosis [show details]
… function and diagnosis of chronic pancreatitis are discussed separately. The normal pancreas shows dilation of the main pancreatic duct over a 5- to 10-minute interval… and/or changes of chronic pancreatitis that are confined to the dorsal area of the pancreas are suggestive of a pathologic minor papillary narrowing in patients with pancreas divisum.…
- 3. 膵外分泌腫瘍の病理pathology of exocrine pancreatic neoplasms [show details]
…of the pancreatic duct, leading to chronic pancreatitis in the obstructed segment of the pancreas. However, because the accessory duct of Santorini can allow bypass of the main pancreatic duct, steatorrhea …
- 4. 膵臓ステント留置術およびその合併症の概要overview of pancreatic stenting and its complications [show details]
… placement for pseudocysts that communicate with the main pancreatic duct. Pancreatic ductal obstruction caused by strictures or stones… pancreatic stents may induce morphologic changes that resemble chronic pancreatitis (dilation of side branches, narrowing,…
- 5. 小児の慢性膵炎および再発性急性膵炎の臨床症状と診断clinical manifestations and diagnosis of chronic and acute recurrent pancreatitis in children [show details]
…changes (irregular contour of the main pancreatic duct or its radicles; intraductal filling defects; calculi, stricture, or dilation) and parenchymal changes (generalized or focal enlargement, irregular contour… Typical findings in chronic pancreatitis include: Calcification within the pancreatic ducts or parenchyma Dilatation of the main pancreatic ducts; Pancreatic atrophy and…
English Journal
- [A case of chronic pancreatitis showing diffuse irregular narrowing of the main pancreatic duct associated with ulcerative colitis and pancreas divisum].
- Nagayama Y, Tanaka S, Yoshida H, Yamamura F, Mikitani K, Kitamura K, Imamura T, Ikegami A, Takahashi A, Sasaki K, Niikawa J, Kato K, Takeuchi H, Mitamura K.
- Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology. 2002 Nov;99(11)1372-80.
- PMID 12462059
- Clinical study of chronic pancreatitis with focal irregular narrowing of the main pancreatic duct and mass formation: comparison with chronic pancreatitis showing diffuse irregular narrowing of the main pancreatic duct.
- Wakabayashi T, Kawaura Y, Satomura Y, Fujii T, Motoo Y, Okai T, Sawabu N.
- Pancreas. 2002 Oct;25(3)283-9.
- Main pancreatic duct (MPD)-narrowed chronic pancreatitis (CP) may be an autoimmune abnormality. It also has been called autoimmune pancreatitis and sclerosing pancreatitis. It is unclear whether cases with focal pancreatographic changes are part of the same clinical entity as cases with diffuse MPD
- PMID 12370540
- [A case of young woman with chronic pancreatitis showing diffuse irregular narrowing of the main pancreatic duct with autoantibody-negative].
- Osaki Y, Kimura T, Hachiya T, Kita R, Maruo T, Tsuji K, Taniguchi Y, Komekado H, Hatano H, Sawabu T, Kokuryu H, Takamatsu S, Fukuyama T, Tomono N.
- Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology. 2002 Jan;99(1)57-63.
- PMID 11831010
Japanese Journal
- 限局性膵管狭細型慢性膵炎の臨床的検討 : びまん性膵管狭細型慢性膵炎との比較を含めて
- 膵管癒合不全をともなう潰瘍性大腸炎に膵管狭細型慢性膵炎を合併した1例
- 永山 芳子,田中 滋城,吉田 仁,山村 冬彦,三木谷 孝誠,北村 勝哉,今村 綱男,池上 覚俊,高橋 章,佐々木 勝己,新川 淳一,加藤 和夫,竹内 治男,三田村 圭二
- 日本消化器病學會雜誌 = The Japanese journal of
- 症例は26歳, 男性. 腹痛, 下痢にて来院. 膵酵素の上昇と膵腫大により, 膵炎と診断.抗生物質, 蛋白分解酵素阻害薬の投与後, 膵管癒合不全が判明し, 膵管狭細型慢性膵炎の合併を認めた. 便潜血陽性が持続し, 大腸内視鏡検査 (CF) により全結腸型の潰瘍性大腸炎 (UC) と診断された. Salazosulphapyridine (SASP) にて治療後UCは寛解し, 膵腫大および膵管狭細像 …
- NAID 10010142101
- Clinical Study of Chronic Pancreatitis with Focal Irregular Narrowing of the Main Pancreatic Duct and Mass Formation : Comparison with Chronic Pancreatitis Showing Diffuse Irregular Narrowing of the Main Pancreatic Duct
- WAKABAYASHI Tokio,KAWAURA Yukimitsu,SATOMURA Yoshitake,FUJII Tomoharu,MOTOO Yoshiharu,OKAI Takashi,SAWABU Norio
- Pancreas 25(3), 283-289, 2002-10-01
- NAID 10013988043
Related Links
- ... signals in the pancreatic lesions similar to pancreatic cancer. 13 ERCP images in AIP patients show segmental or diffuse narrowing of the main pancreatic duct. 5, 16 Although magnetic resonance cholangiopancreatography ...
- Irregular Narrowing of the Main Pancreatic Duct in Association With a Wall Thickening Is a Key Sign at Endoscopic Ultrasonography for the Diagnosis of Autoimmune Pancreatitis Palazzo, Maxime MD *; Palazzo, Laurent MD †; Aubert, Alain MD ...
- Background Autoimmune pancreatitis (AIP) is a rare cause of chronic pancreatitis. Case outline A case of obstructive jaundice with pancreatic mass mimicking malignancy is described. Discussion Recognition of the ...
★リンクテーブル★
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- 英
- autoimmune pancreatitis AIP
- 同
- 膵管狭細型慢性膵炎 chronic pancreatitis showing irregular narrowing of main pancreatic duct
- 関
- 膵炎
疫学
病態
- 参考2
- 膵外分泌障害(約80%)
- 膵内分泌障害(糖尿病)(70%)
症候
合併症
検査
- 参考2 (%)内は頻度
- 膵酵素、肝胆道系酵素(60-82%)、総ビリルビン上昇(39-62%)
- 参考2 (%)内は頻度
- 高γグロブリン血症:≧2 g/dl (43%)
- 高IgG血症:≧1800 mg/dl (62-80%)
- 高IgG4血症:≧135 mg/dl (68-92%) 疾患特異的ではない
- 自己抗体:陽性
- 超音波検査:
- CT:びまん性あるいは限局性の膵腫大。被膜様構造(capsule-like rim)が認められ、この被膜は膵実質相では病変部の膵実質よりも低吸収を示し、ダイナミックCTでは遅延性増強パターンを示す。(参考2)
- [show details]
- [show details]
診断基準
- 自己免疫性膵炎診断基準(改定案)(厚生労働省難治性膵疾患調査研究班・日本本膵臓学会)
- 高γグロブリン血症(2g/dl以上)、
- 高IgG血症(1800 mg/dl以上)、
- 高IgG4血症(135 mg/dl以上)
- 自己抗体のいずれかを認める
- 膵にリンパ球・形質細胞を主とする著明な細胞浸潤と線維化を認める
- 上記の1を含んで2項目以上満たす症例を自己免疫性膵炎と診断する
- ただし膵癌胆管癌などの悪性疾患を除外することが必要である
診断
鑑別診断
治療
参考
- 1. 自己免疫性膵炎/IgG4関連疾患 信州医誌,58.:3~10,2010
- http://s-igaku.umin.jp/DATA/58_01/58_01_02.pdf
- http://www.jstage.jst.go.jp/browse/suizo/24/Supplement/_contents/-char/ja/
- http://www.shinshu-u.ac.jp/faculty/medicine/chair/i-1nai/news/images/0807/yokoyama.pdf
国試
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- 英
- chronic pancreatitis showing irregular narrowing of main pancreatic duct
- 関
- 自己免疫性膵炎
[★]
- 関
- cardinal、chief、chiefly、foremost、mainly、major、master、mostly、predominant、predominantly、primarily、primary、principal、principally
[★]
- 関
- canal、conduit、ductal、ductus、meatus、pipe、tubal、tube、vas、vessel
[★]
- 関
- irregularity、irregularly
[★]
- 関
- chronically、chronicity
[★]
- 関
- pancreas、pancreata