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Severe self limiting sclerosing cholangitis after pancreaticoduodenectomy due to autoimmune pancreatitis
  1. A Schmassmann1,
  2. P Zehnder2,
  3. J-O Gebbers3,
  4. A Wildisen4
  1. 1Department of Internal Medicine, Kantonales Spital Sursee and University of Berne, Switzerland
  2. 2Department of General and Visceral Surgery, Kantonales Spital Sursee, Switzerland
  3. 3Department of Pathology, Kantonsspital Luzern, Switzerland
  4. 4Department of General and Visceral Surgery, Kantonales Spital Sursee, Switzerland
  1. Correspondence to:
    Professor A Schmassmann
    Department of Internal Medicine, Kantonales Spital Sursee and University of Berne, Switzerland; adrian.schmassmann{at}kssw.ch

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Autoimmune pancreatitis is a chronic inflammatory disease of the pancreas that often mimics pancreatic malignancy. However, laboratory, radiological, and histological findings can be quite characteristic.1,2 Early clinical suspicion of this diagnosis is decisive. High titres of serum gamma globulins (especially immunoglobulin G4), autoimmune antibodies, and characteristic radiological and histological features strongly support the diagnosis.1,2 Steroid therapy usually substantially improves clinical, laboratory, and radiological parameters. Nevertheless, in some cases, surgical resection of a pancreatic mass lesion is still necessary, mainly to exclude pancreatic cancer and to treat low bile duct strictures.1 Sclerosing cholangitis associated with autoimmune pancreatitis is part of a systemic fibroinflammatory response and can develop before, during, and after the development of autoimmune pancreatitis.1,2

A 66 year old man was admitted …

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