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Case Reports
, 130 (17-18), 545-556

Clinical-Pathological Conference Series From the Medical University of Graz : Case No 161: A 42-year-old Journalist With Fatigue, Elevated Liver Function Tests, Hyperglycemia and Pruritus

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Case Reports

Clinical-Pathological Conference Series From the Medical University of Graz : Case No 161: A 42-year-old Journalist With Fatigue, Elevated Liver Function Tests, Hyperglycemia and Pruritus

Elisabeth Fabian et al. Wien Klin Wochenschr.

Abstract

No abstract available

Keywords: Autoimmune pancreatitis type 1; Cholestasis; IgG4; Leukocytoclastic vasculitis; Total pancreatectomy.

Conflict of interest statement

E. Fabian, M. Peck-Radosavljevic, E. Krones, H. Mueller, C. Lackner, C. Spreizer, C. Putz-Bankuti, W. Fuerst, N. Wutte, P. Fickert, H. Mischinger and G.J. Krejs declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a,b Contrast-enhanced CT showing diffuse enlargement of the body of the pancreas (P) with loss of lobular structure. c,d T1-weighted fat-saturated contrast-enhanced magnetic resonance images showing an ill-defined hyopodense lesion (arrows) in the head of the pancreas. These findings were interpreted as being consistent with a carcinoma (or cystadenocarcinoma) of the head of the pancreas with diffuse infiltration of the body of the pancreas
Fig. 2
Fig. 2
a Intraoperative view of the body of the pancreas. An inflammatory fibrotic capsule with adjacent fatty tissue covers the pancreas, which appears to harbor multiple small masses and cysts. b Intraoperative situs after resection of the proximal pancreas with (P) residual pancreatic tail with clamped main pancreatic duct, superior mesenteric vein (SMV), portal vein (PV), splenic vein (VL) and common hepatic artery (AH)
Fig. 3
Fig. 3
a Most of the pancreatic parenchyma (lower left corner) is replaced by fibrosis with a storiform pattern. b Numerous inflammatory cells infiltrate the wall of a venous vessel (venolitis). c Pancreatic duct surrounded by storiform fibrosis and inflammatory infiltrates. d The periductal infiltrate contains lymphocytes and numerous plasma cells
Fig. 4
Fig. 4
Purpuric, partly confluent plaques up to 1.5 cm in size on the lower extremities with central bullous transformation in larger lesions
Fig. 5
Fig. 5
Skin biopsy showing leukocytoclastic vasculitis. Perivascular infiltrate of neutrophilic and eosinophilic granulocytes (gc) with focal leukocytoclasis in the superficial dermis, fibroid necrosis of the vessel walls (n)

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References

    1. Moro P, Schantz PM. Echinococcoisis: A review. Int J Infect Dis. 2009;13:125–133. doi: 10.1016/j.ijid.2008.03.037. - DOI - PubMed
    1. World Health Organization. Informal Working Group (IFWG) International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop. 2003;85:253–261. doi: 10.1016/S0001-706X(02)00223-1. - DOI - PubMed
    1. Fabian E, Madl C, Horn S, Kornprat P, Maderthaner R, Aigelsreiter A, Krause R, Fickert P, Krejs GJ. Clinical-pathological conference series from the Medical University of Graz: case no. 151: 19-year-old student from Albania with emergency admission due to shock. Wien Klin Wochenschr. 2015;127(3–4):151–159. doi: 10.1007/s00508-014-0636-z. - DOI - PubMed
    1. Green RM, Flamm S. AGA technical review on the evaluation of liver chemistry tests. Gastroenterology. 2002;123(4):1367–1384. doi: 10.1053/gast.2002.36061. - DOI - PubMed
    1. Nishimura T, Masaoka T, Suzuki H, Aiura K, Nagata H, Ishii H. Autoimmune pancreatitis with pseudocysts. J Gastroenterol. 2004;39(10):1005–1010. doi: 10.1007/s00535-004-1436-4. - DOI - PubMed

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