新冠肺炎疫苗注射後出現之自體免疫性胰臟炎
 
詹崴宇¹劉子弘^2,3余忠泰^3,4陳建華^1,3

 
自體免疫性胰臟炎是少見的疾病，表現通常為無痛性黃疸。若合併胰臟頭部腫塊，常被誤認為胰臟癌。此疾病對於類固醇反應良好，早期的診斷可以避免胰臟反覆發炎造成併發症，也可以使病人免於不必要的手術。病人為68歲男性，在注射AstraZeneca COVID-19 Vaccine（AZ疫苗）產生過敏反應後，因肝功能持續異常、胰臟腫大、胰頭腫瘤與阻塞性黃疸於肝膽腸胃科診治，經影像、抽血及切片檢查確診為自體免疫性胰臟炎，給予類固醇治療後反應良好，影像表現及血液學檢查完全恢復正常。希望藉由此文章，讓更多醫師認識此病，在臨床上遇到無痛性黃疸併胰臟病灶時，能將此疾病納入鑑別診斷。
(台灣家醫誌2022; 32: 309-317) DOI: 10.53106/168232812022123204007
 
關鍵詞：自體免疫性胰臟炎、胰臟炎、黃疸、免疫球蛋白G4
 

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¹佛教慈濟醫療財團法人台北慈濟醫院內科、²佛教慈濟醫療財團法人台北慈濟醫院家庭醫學科、³慈濟大學醫學院、⁴佛教慈濟醫療財團法人台北慈濟醫院解剖病理科
受理日期：111年3月28日 修改日期：111年4月20日 同意刊登：111年6月23日
通訊作者：陳建華 通訊地址：新北市新店區建國路289號E-mail: jhctylci@gmail.com

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Autoimmune Pancreatitis after Getting a COVID-19
Vaccine: A Case Report
 
Wei-Yu Chan¹, Tzu-Hung Liu^2,3, Chung-Tai Yue^3,4 and Jiann-Hwa Chen^1,3

 
A rare disease characterized by painless jaundice, autoimmune pancreatitis could mimic pancreatic cancer with the presence of pancreatic head tumor. The disease responds well to steroids, and early diagnosis can avoid unnecessary surgery and complications caused by recurrent inflammation of the pancreas. The patient was a 68-year-old man receiving examination and treatment at our gastroenterology department for persistent abnormal results for liver function tests, swollen pancreas, a pancreatic head tumor, and obstructive jaundice after alergic reaction caused by Vaxzevria (AstraZeneca) COVID-19 vaccination. Autoimmune pancreatitis was diagnosed after image examination and laboratory and pathology tests. The patient recovered well after treatment with steroids. The abnormality previously noted returned to complete normality. In conclusion, when physicians encounter a patient with painless jaundice and pancreatic lesions, autoimmune pancreatitis, although uncommon, should be considered for differential diagnoses.
(Taiwan J Fam Med 2022; 32: 309-317) DOI: 10.53106/168232812022123204007
 
Key words: autoimmune pancreatitis, pancreatitis, jaundice, IgG4
 

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¹Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
²Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
³School of Medicine, Tzu Chi University, Hualien, Taiwan.
⁴Department of Anatomic Pathology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Received: March 28, 2022; Revised: April 20, 2022; Accepted: June 23, 2022.