2012 Volume 27 Issue 4 Pages 626-632
A 60-year-old woman was diagnosed with autoimmune pancreatitis (AIP) of the tail of the pancreas in 2001. She recovered following steroid therapy; however, approximately 1 year after discontinuing treatment, AIP relapsed at the head of the pancreas, resulting in obstructive jaundice. Steroid therapy was restarted and again tapered after the patient recovered. As a maintenance dose, she continued to take prednisolone (5mg) on alternate days; nevertheless, AIP recurred at the head and the tail of the pancreas and intra-hepatic biliary strictures in 2008. Although steroid therapy is usually maintained for at least 3 years, some patients may need longer maintenance therapy, particularly patients with diffuse pancreas swelling, proximal bile duct involvement, and extra-pancreatic lesions. Our case suggests that AIP requires more careful observation because this condition can recur several times at different sites, even after 6 years of steroid maintenance therapy.
