Autoimmune Pancreatitis with Gastric Cancer: Some IgG4-related Diseases May Be Paraneoplastic Syndrome

Koichiro Miyagawa; Keiichiro Kumamoto; Nobuhiko Shinohara; Tatsuyuki Watanabe; Shinsuke Kumei; Akitoshi Yoneda; Satoru Nebuya; Yudai Koya; Shinji Oe; Keiichiro Kume; Ichiro Yoshikawa; Masaru Harada

doi:10.2169/internalmedicine.8590-21

CASE REPORTS

Autoimmune Pancreatitis with Gastric Cancer: Some IgG4-related Diseases May Be Paraneoplastic Syndrome

Koichiro Miyagawa, Keiichiro Kumamoto, Nobuhiko Shinohara, Tatsuyuki Watanabe, Shinsuke Kumei, Akitoshi Yoneda, Satoru Nebuya, Yudai Koya, Shinji Oe, Keiichiro Kume, Ichiro Yoshikawa, Masaru Harada

Author information

Koichiro Miyagawa
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Keiichiro Kumamoto
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Nobuhiko Shinohara
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Tatsuyuki Watanabe
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Shinsuke Kumei
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Akitoshi Yoneda
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Satoru Nebuya
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Yudai Koya
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Shinji Oe
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Keiichiro Kume
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Ichiro Yoshikawa
Department of Endoscopy, University Hospital of Occupational and Environmental Health, Japan
Masaru Harada
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan

Keywords: autoimmune pancreatitis, early gastric cancer, paraneoplastic syndrome

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 14 Pages 2155-2160

DOI https://doi.org/10.2169/internalmedicine.8590-21

Details

Abstract

A 70-year-old man was referred to our department for the treatment of early gastric cancer. Contrast-enhanced computed tomography (CT) incidentally showed diffuse enlargement of the pancreas with a capsule-like rim, and blood tests showed elevated serum IgG4 levels, leading to a diagnosis of autoimmune pancreatitis (AIP). Endoscopic treatment for gastric cancer was performed, and pathological findings showed adenocarcinoma with abundant IgG4-positive plasma cell infiltration. Thereafter, the serum IgG4 levels normalized, and the findings of AIP disappeared on CT without steroid treatment. These findings suggest that the gastric cancer activated an IgG4-related immune response, resulting in the development of AIP.

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