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Miscellanea
Images in paediatrics
Autoimmune pancreatitis in a child: a challenging diagnosis
  1. Graham King1,
  2. Emer O'Toole1,
  3. Kevin O'Hare2,
  4. Barbara M. Ryan3,
  5. Basil Elnazir4,
  6. Shoana Quinn1
  1. 1 Paediatric Gastroenterology, Children's Health Ireland at Tallaght, Dublin, Ireland
  2. 2 Pathology, Tallaght University Hospital, Dublin, Ireland
  3. 3 Adult Gastroenterology, Tallaght University Hospital, Dublin, Ireland
  4. 4 General Paediatrics, Children's Health Ireland at Tallaght, Dublin, Ireland
  1. Correspondence to Dr Graham King, Paediatric Gastroenterology Secretary, Tallaght University Hospital, Dublin D24 NR0A, Ireland; graham.king{at}hse.ie

http://dx.doi.org/10.1136/archdischild-2019-318287

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    A 13-year-old boy presented with a 4-day history of vomiting, jaundice, pruritus, pale stools and dark urine. He was apyrexic and had right-upper-quadrant abdominal tenderness. He had raised alkaline-phosphatase (620 U/L), gamma-glutamyl-transferase (435 U/L), total bilirubin (102 μmol/L), direct bilirubin (94 μmol/L), alanine-transaminase (123 U/L) and lipase (68 U/L), but normal amylase (37 U/L), faecal elastase (232 µg/g) and serum IgG4 levels.

    Transabdominal ultrasound showed a distended gallbladder and dilated common bile duct (15 mm). He received prophylactic pancreatic enzyme supplementation, vitamin K, cholestyramine, rifampicin and …

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    Footnotes

    • Contributors All authors equally contributed to the draft of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.