Autoimunski pankreatitis tipa 1 i 2

Irina A. Brčerević; Radoje Doder; Nenad Perišić; Stanko Petrović; Jasna Jović; Dejan Hristović; Zoran Djordjević; Olga Tasić Radić

doi:10.2298/VSP151007192B

Irina A. Brčerević Clinic for Gastroenterology and Hepathology,Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Radoje Doder Clinic for Gastroenterology and Hepathology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Nenad Perišić Clinic for Gastroenterology and Hepathology, Military Medical Academy, Belgrade, Serbia
Stanko Petrović Clinic for Gastroenterology and Hepathology, Military Medical Academy, Belgrade, Serbia
Jasna Jović Clinic for Gastroenterology and Hepathology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Dejan Hristović Clinic for Infectious and Tropical Diseases, Military Medical Academy, Belgrade, Serbia
Zoran Djordjević Institute of Radiology, Military Medical Academy, Belgrade, Serbia
Olga Tasić Radić Institute of Pathology, Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP151007192B

Ključne reči: pancreatitis||, ||pankreatitis, autoimmune diseases||, ||autoimunske bolesti, diagnostic techniques and procedures||, ||dijagnostičke tehnike i procedure, diagnosis, differential||, ||dijagnoza, diferencijalna, drug therapy||, ||lečenje lekovima,

Sažetak

Uvod. Autoimunski pankreatitis (AP) je oboljenje čiji nastanak se povezuje sa autoimunskim mehanizmima i klinički se najčešće manifestuje opstruktivnim ikterusom sa ili bez uvećanja čitavog ili dela pankreasa, histološki limfoplazmocitnom infiltracijom, fibrozom ili granulocitno-epitelnim lezijama uz povoljan terapijski odgovor na primenu kortikosteroida. AP tipa 1 je sistemsko oboljenje koje pripada grupi IgG4 udruženih bolesti. Prikaz bolesnika. Prikazali smo dva bolesnika. Prvi bolesnik, star 64 godine, sa AP tipa 1, žalio se na bolove u trbuhu, gubitak telesne mase, slabost i malaksalost. Kliničko ispitivanje pokazalo je da se radi o retkom IgG4 AP. Drugi bolesnik, star 37 godina, na prijemu imao je stomačne bolove u predelu pojasa i tečne stolice. Postavljena dijagnoza otkrila je prisustvo autoimunskog pankreatitisa tipa 2. Oba bolesnika lečena su imunosupresivnom terapijom koja je popravila njihovo opšte stanje. Zaključak. AP predstavlja retko oboljenje koje je nekada teško razlikovati od tumora pankreasa ili bilijarnog trakta koji ima lošu prognozu. Stoga, veoma je važna rana dijagnoza pošto adekvatno lečenje značajno poboljšava tok i ishod bolesti.

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