The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Autoimmune Pancreatitis Featuring a Pseudocyst Requiring Drainage despite Steroid Therapy

스테로이드 치료에도 불구하고 낭종 배액술이 필요하였던 가성낭종을 동반한 자가면역 췌장염

  • Park, Jae Cheol (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Im, Hyeon-Su (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kang, Yewon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Son, Hyo-Ju (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Kyung Hwa (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Han, Jisoo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Myung-Hwan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 박재철 (울산대학교 의과대학 서울아산병원 내과) ;
  • 임현수 (울산대학교 의과대학 서울아산병원 내과) ;
  • 강예원 (울산대학교 의과대학 서울아산병원 내과) ;
  • 손효주 (울산대학교 의과대학 서울아산병원 내과) ;
  • 정경화 (울산대학교 의과대학 서울아산병원 내과) ;
  • 한지수 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김명환 (울산대학교 의과대학 서울아산병원 내과)
  • Received : 2017.05.29
  • Accepted : 2017.10.26
  • Published : 2018.12.01
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Abstract

Autoimmune pancreatitis (AIP) is rarely associated with pancreatic pseudocysts. AIP-associated pseudocysts requiring drainage despite steroid therapy are rather rare. We report a case of AIP with an infected pseudocyst requiring drainage despite steroid therapy. A 68-year-old male was diagnosed with AIP via pancreatic imaging, a high serum immunoglobulin G4 level, and steroid responsiveness. The AIP was accompanied by a pancreatic pseudocyst. Steroid therapy was prescribed, but the pancreatic pseudocyst became aggravated during steroid tapering. Endoscopic ultrasonography-guided cyst drainage was required; the pseudocyst then became completely resolved.

자가면역 췌장염 환자에서 드물지만 가성낭종이 동반될 수 있다. 자가면역 췌장염에 동반된 가성낭종은 대부분 스테로이드 투여만으로 소실된다고 알려져 있다. 하지만 본 증례에서는 스테로이드 투여에도 불구하고 가성낭종의 크기가 증가하였고, 이차적으로 낭종내 감염이 발생하였다. 이에 초음파내시경을 이용하여 낭종 배액술을 시행하였으며, 이를 통하여 가성낭종이 완전히 소실되었다.

Keywords

References

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