Journal
INTERNAL MEDICINE
Volume 61, Issue 14, Pages 2155-2160Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.8590-21
Keywords
autoimmune pancreatitis; early gastric cancer; paraneoplastic syndrome
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This study reports a case of early gastric cancer with concomitant autoimmune pancreatitis. The findings suggest that gastric cancer may activate an IgG4-related immune response, leading to the development of autoimmune pancreatitis.
A 70-year-old man was referred to our department for the treatment of early gastric cancer. Contrastenhanced computed tomography (CT) incidentally showed diffuse enlargement of the pancreas with a capsule-like rim, and blood tests showed elevated serum IgG4 levels, leading to a diagnosis of autoimmune pancreatitis (AIP). Endoscopic treatment for gastric cancer was performed, and pathological findings showed adenocarcinoma with abundant IgG4-positive plasma cell infiltration. Thereafter, the serum IgG4 levels normalized, and the findings of AIP disappeared on CT without steroid treatment. These findings suggest that the gastric cancer activated an IgG4-related immune response, resulting in the development of AIP.
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