Autoimmune Pancreatitis: Associated Hepatomegaly and Splenomegaly

Introduction: The Pancreatitis autoimmune is an entity which has recently raised interest in its description, associated in the majority of reports from the international specialised literature to chronic pancreatitis events, pancreatic cancer, and associated to demonstrations of autoimmunity, with presence of autoantibodies. Autoimmune pancreatitis is a benign fibroinflammatory disease of the pancreas of probable autoimmune origin, which includes 2 different phenotypes: type 1 (lymphoplasmacytic sclerosing pancreatitis) and type 2 (idiopathic duct-centric pancreatitis). Its clinical presentation as obstructive jaundice in patients with a pancreatic mass is common and therefore it must be included in the differential diagnosis of pancreatic neoplasia. Many diagnostic criteria have been described. The most famous are the HISORT criteria of the Mayo Clinic and the international consensus criteria of 2011. Clinical case: We present the case of a woman aged 33, with clinical data of abdominal pain, nauseous state, vomits and presence of hepatomegaly of 17 cm (6.69 in) below the flange costal and splenomegaly weighing 975 gm (2.1 lb) in addition to fever reaching 38.8°C (101.8°F) of nocturnal predominance and diaphoresis with 32 months of evolution and weight loss around 4 kilos (11lb) for the last 4 months. Discussion: The pancreatitis autoimmune is an entity little known with less than 100 cases registered in the literature, however, immune data prevail, a presumptive diagnosis was done with assessment criteria of: pancreas diffuse enlargement (which is of the essence), anti-bodies and data histopathologic of periductal fibrosis or segmentary of the main pancreatic duct and lymphoplasmocitary infiltration in pancreas and the answer to steroids was significant. But both Japanese and American society in their publications, to establish the diagnostic criteria, are met, especially from Japanese society, which establishes 3 of the published criteria, such as alterations in image, serology, response to steroid treatment and absence of malignancy, It is practically the same in the criteria of HISORT with the exception of histological studies, Japan Pancreas society, establishes 3 criterions present at the time of diagnosis by Japan Pancreas society initially and currently are still using. Key words: Autoimmune pancreatitis; Study fever; Hepatomegaly and Splenomegaly in study; Autoimmune disease