Glucocorticoid therapy in pancreatic portal hypertension associated with autoimmune pancreatitis: A case report

• Published in: World journal of clinical cases 2024-08, Vol.12 (22), p.5184-5188
• Main Authors: Zhang, Yi, Li, Zhao-Dong, He, Yuan-Jing, Peng, Wei, Luo, Yu-Jun, Li, Xiao-An
• Format: Article
• Language: English
• Subjects: Case Report
• ISSN: 2307-8960; 2307-8960
• DOI: 10.12998/wjcc.v12.i22.5184

Autoimmune pancreatitis (AIP) is a chronic form of pancreatitis characterized by diffused enlargement of the pancreas and irregular stenosis of the main pancreatic duct. Some studies have reported that AIP can cause hemorrhage of gastric varices (GV) related to portal hypertension (PH). However, such cases are rare. In addition, the association of PH with AIP is unclear. At the same time, the efficacy and duration of glucocorticoid therapy is also controversial. In this case, we reported a case of GV in pancreatic PH associated with AIP. Enhanced abdominal computed tomography (CT) suggested splenic vein (SV) and superior mesenteric vein (SMV) thromboses. The patient received a long-term glucocorticoid therapy, that the initial dose of 40 mg is reduced weekly by 5 mg, and then reduced to 5 mg for long-term maintenance. CT and gastroscopic examination after 8 mo of treatment indicated that SV and SMV were recanalized, pancreatic stiffness and swelling were ameliorated, and the GV almost completely disappeared. Long-term glucocorticoid therapy can alleviate the development of GV in patients with AIP and has potential reversibility.