Diagnosis of Autoimmune Pancreatitis vs Neoplasms in Children With Pancreatic Mass and Biliary Obstruction

Joel Friedlander, J. Antonio Quiros, Terry Morgan, Zili Zhang, Wei Tian, Elizabeth Kehr, Dustin V. Shackleton, Andrew Zigman, Peter Stenzel

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Autoimmune pancreatitis (AIP) is a rare autoimmune disorder that resembles pancreatic neoplasia and occurs primarily in adults. Management strategies and diagnostic criteria are being revised for adult patients; there are no clear diagnostic criteria for pediatric patients. We describe 3 cases of AIP in children, on the basis of clinical and pathology records. We also performed a literature review to determine the incidence of biliary obstruction in pediatric patients with pancreatic tumors. We found that children with AIP present with a variety of symptoms, and that diagnostic and therapeutic strategies also vary. Furthermore, on the basis of the many studies published on pediatric patients with pancreatic tumors, only a small percentage of the patients have biliary obstructions. Cytologic analysis of samples collected by fine-needle aspiration cytology does not accurately identify AIP in children. However, frozen section needle core biopsy samples can be used to distinguish children with AIP from those with neoplasia. Children with pancreatic mass and biliary obstruction are more likely to have AIP than neoplasms.

Original languageEnglish (US)
Pages (from-to)1051-1055.e1
JournalClinical Gastroenterology and Hepatology
Volume10
Issue number9
DOIs
StatePublished - Sep 2012

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Keywords

  • Autoimmune Pancreatitis
  • Diagnostic Factor
  • Inflammation
  • Obstructive Jaundice
  • Pain
  • Pancreas
  • Pancreatic Mass
  • Pancreatic Neoplasia
  • Pediatric Gastroenterology
  • Recurrent Pancreatitis
  • Tumor

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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