以糖尿病为首发症状的IgG4相关性自身免疫胰腺炎一例并文献复习

目的：分析以糖尿病起病的自身免疫性胰腺炎（AIP）患者临床特征。方法收集并总结中日友好医院内分泌科2015年3月收治的1例60岁男性AIP患者病例资料，随访治疗过程中胰腺外分泌腺和内分泌腺功能转归。结果以糖尿病为首发症状的AIP患者胰岛功能示绝对缺乏，胰岛细胞抗体、胰岛素自身抗体、谷氨酸脱羧酶抗体阴性，脂肪酶801 U/L。磁共振胰胆管造影发现胰腺肿胀。醋酸泼尼松治疗4个月后胰腺肿胀明显缩小，脂肪酶正常，醋酸泼尼松治疗期间胰岛素总剂量无改变。结论对于患者临床特征介于1型及2型糖尿病之间，自身抗体阴性，无糖尿病家族史，合并其他系统症状患者应进一步筛查IgG4相关性疾病。...

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Published in中华糖尿病杂志 Vol. 8; no. 7; pp. 414 - 417
Main Author 王娜 邢小燕 陈晓平 张波 金仙 李照青 杨文英
Format Journal Article
LanguageChinese
Published 中日友好医院内分泌科,北京,100029 2016
Subjects
IgG4相关性疾病
糖尿病
自身免疫性胰腺炎
IgG4-related disease
自身免疫性胰腺炎
糖尿病
IgG4相关性疾病
Autoimmune pancreatitis
Diabetes mellitus
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Summary:目的：分析以糖尿病起病的自身免疫性胰腺炎（AIP）患者临床特征。方法收集并总结中日友好医院内分泌科2015年3月收治的1例60岁男性AIP患者病例资料，随访治疗过程中胰腺外分泌腺和内分泌腺功能转归。结果以糖尿病为首发症状的AIP患者胰岛功能示绝对缺乏，胰岛细胞抗体、胰岛素自身抗体、谷氨酸脱羧酶抗体阴性，脂肪酶801 U/L。磁共振胰胆管造影发现胰腺肿胀。醋酸泼尼松治疗4个月后胰腺肿胀明显缩小，脂肪酶正常，醋酸泼尼松治疗期间胰岛素总剂量无改变。结论对于患者临床特征介于1型及2型糖尿病之间，自身抗体阴性，无糖尿病家族史，合并其他系统症状患者应进一步筛查IgG4相关性疾病。
Bibliography:Wang Na, Xing Xiaoyan, Chen Xiaoping, Zhang Bo, Jin Xian, Li Zhaoqing, Yang Wenying（ Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China）
Objective To summarize the clinical features of autoimmune pancreatitis （AIP） with diabetes as the initial symptom. Methods The clinical data of one case of AIP with diabetes as the initial symptom were analyzed. The 60-year-old male patient was diagnosed in March 2015 in the Department of Endocrinology in China？Japan Friendship Hospital. A follow-up study focused on the pancreatic endocrine and exocrine functions was conducted. Results Based on observation, the insulin secretion function in the patient was poor, whereas the glutamic acid decarboxylase antibody, insulin autoantibody and islet cell autoantibody were found negative. In addition, the lipase level was 801 U/L. The swelling of pancreas was found under magnetic resonance cholangiopancreatography. The patients was treated with prednisone for 4 months, the pancreatic swelling ameliora
ISSN:1674-5809
DOI:10.3760/cma.j.issn.1674-5809.2016.07.008