Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba

Background: The differential diagnosis of pancreatic cancer and focal forms of autoimmune pancreatitis is complicated since serological tests, IgG4 and CA 19-9 have a low sensibility and specificity. CT scan and magnetic resonance imaging provide clear differentiation in the majority, but not in all...

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Autor principal:	Berger,Zoltán
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2014
Materias:	Autoimmunity Pancreatitis, acute necrotizing Pancreatic neoplasms
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872014000400001
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spelling	oai:scielo:S0034-988720140004000012014-09-02Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de pruebaBerger,Zoltán Autoimmunity Pancreatitis, acute necrotizing Pancreatic neoplasms Background: The differential diagnosis of pancreatic cancer and focal forms of autoimmune pancreatitis is complicated since serological tests, IgG4 and CA 19-9 have a low sensibility and specificity. CT scan and magnetic resonance imaging provide clear differentiation in the majority, but not in all cases. Endosonography is the most precise diagnostic procedure and allows to obtain samples for cytology or even histological studies. Aim: To report the experience with 18 cases of focal autoimmune pancreatitis and three cases of pancreatic cancer. Material and Methods: Review of medical records of 18 patients with focal autoimmune pancreatitis and 3 cases of pancreatic cancer. Results: The eighteen patients with focal autoimmune pancreatitis were treated with prednisone 0.5 mg/kg/day obtaining a complete clinical and morphological recovery in all. However, 3 had a relapse and one was operated. During follow up, none has developed a pancreatic cancer. The 3 patients with pancreatic cancer did not respond to steroidal treatment. Conclusions: The quick and dramatic response to steroids of autoimmune pancreatitis, may be useful and is recommended for the differential diagnosis with pancreatic cancer.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.142 n.4 20142014-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872014000400001es10.4067/S0034-98872014000400001
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Autoimmunity Pancreatitis, acute necrotizing Pancreatic neoplasms
spellingShingle	Autoimmunity Pancreatitis, acute necrotizing Pancreatic neoplasms Berger,Zoltán Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba
description	Background: The differential diagnosis of pancreatic cancer and focal forms of autoimmune pancreatitis is complicated since serological tests, IgG4 and CA 19-9 have a low sensibility and specificity. CT scan and magnetic resonance imaging provide clear differentiation in the majority, but not in all cases. Endosonography is the most precise diagnostic procedure and allows to obtain samples for cytology or even histological studies. Aim: To report the experience with 18 cases of focal autoimmune pancreatitis and three cases of pancreatic cancer. Material and Methods: Review of medical records of 18 patients with focal autoimmune pancreatitis and 3 cases of pancreatic cancer. Results: The eighteen patients with focal autoimmune pancreatitis were treated with prednisone 0.5 mg/kg/day obtaining a complete clinical and morphological recovery in all. However, 3 had a relapse and one was operated. During follow up, none has developed a pancreatic cancer. The 3 patients with pancreatic cancer did not respond to steroidal treatment. Conclusions: The quick and dramatic response to steroids of autoimmune pancreatitis, may be useful and is recommended for the differential diagnosis with pancreatic cancer.
author	Berger,Zoltán
author_facet	Berger,Zoltán
author_sort	Berger,Zoltán
title	Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba
title_short	Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba
title_full	Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba
title_fullStr	Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba
title_full_unstemmed	Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba
title_sort	un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. el valor del tratamiento esteroidal de prueba
publisher	Sociedad Médica de Santiago
publishDate	2014
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872014000400001
work_keys_str_mv	AT bergerzoltan undesafioclinicodiagnosticodiferencialdepancreatitisautoinmuneycancerdepancreaselvalordeltratamientoesteroidaldeprueba
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Un desafío clínico: diagnóstico diferencial de pancreatitis autoinmune y cáncer de páncreas. El valor del tratamiento esteroidal de prueba

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