Year 2024 / Volume 31 / Number 3

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Cilinical Note

Autoimmune pancreatitis in a patient with systemic lupus erythematosus: case report

Rev. Soc. Esp. Dolor. 2024; 31(3): 176-179 / DOI: 10.20986/resed.2025.4167/2024

Claudia Liliana Buitrago, Diana María Solarte, Leonardo Arce


ABSTRACT

Introduction: Autoimmune pancreatitis is a difficultto-diagnose condition that can be associated with autoimmune diseases, presenting with significant symptoms such as abdominal pain and jaundice. It requires a thorough evaluation of signs, symptoms, and treatment to establish the diagnosis.
Objective: To present the case of a young adult female patient with a history of systemic lupus erythematosus with multiple complications, who presents with autoimmune pancreatitis and difficult-to-manage pain.
Case report: A 20-year-old patient with a history of systemic lupus erythematosus, involving multiple domains such as cutaneous, renal, and serous membranes, presents with autoimmune pancreatitis, associated with imaging and serological findings. She has significant abdominal pain that is difficult to manage despite treatment with multimodal analgesia, showing improvement with the use of corticosteroids.
Discussion: Autoimmune pancreatitis is a difficultto-diagnose condition related to autoimmune diseases, with symptoms that can be compatible with different pathologies, whether obstructive or oncological. The clinical presentation of autoimmune pancreatitis can vary and mimic other conditions, underscoring the need for a thorough diagnostic approach. Abdominal pain is one of the symptoms associated with this condition. In our case, the difficult diagnosis and insufficient response to multimodal treatment made it a challenge. The patient showed an excellent response to the use of corticosteroids, which was crucial in establishing the diagnosis. The administration of corticosteroids resulted in significant pain relief, which not only provided symptomatic relief but also served as a crucial diagnostic indicator.
Conclusion: We present the case report of a female patient with a history of systemic lupus erythematosus who presented with multi-organ involvement and a presumed diagnosis of autoimmune pancreatitis, with difficult-to-control abdominal pain requiring multiple analgesic therapies. The marked improvement in pain with the use of corticosteroid therapy was a key diagnostic criterion for this condition. This case highlights the importance of considering autoimmune pancreatitis in patients with autoimmune diseases and the effectiveness of corticosteroids in managing the pain associated with this condition. The experience gained from this case may be valuable for future diagnoses and treatments of patients with similar clinical presentations.



RESUMEN

Introducción: La pancreatitis autoinmune es una patología de difícil diagnóstico que puede estar asociada a enfermedades autoinmunes, con síntomas relevantes como dolor abdominal e ictericia. Requiere una adecuada evaluación de signos, síntomas y tratamiento para establecer el diagnóstico.
Objetivo: Presentar el caso de una paciente adulta joven con antecedente de lupus eritematoso sistémico con múltiples complicaciones, quien presenta cuadro de pancreatitis autoinmune, con difícil manejo del dolor.
Caso clínico: Paciente de 20 años con antecedente de lupus eritematoso sistémico, con compromiso de múltiples dominios cutáneo, renal y de serosas, quien presenta cuadro de pancreatitis autoinmune, asociado a hallazgos imagenológicos y serológicos. Con síntoma relevante de dolor abdominal, de difícil manejo a pesar del tratamiento con el uso de analgesia multimodal, con evidencia de mejoría del mismo al uso de corticoides.
Discusión: La pancreatitis autoinmune es una patología de difícil diagnóstico, relacionado con enfermedades autoinmunes, con sintomatología compatible con diferentes patologías, ya sea obstructivas u oncológicas. La presentación clínica de la pancreatitis autoinmune puede ser variada y mimetizar otras condiciones, lo que subraya la necesidad de un enfoque diagnóstico exhaustivo. El dolor abdominal es uno de los síntomas que se presenta asociado a esta patología. En nuestro caso, el difícil diagnóstico y la insuficiente respuesta al tratamiento multimodal lo convierten en un reto. La paciente presentó una excelente respuesta al uso de corticoides, lo que fue fundamental para establecer el diagnóstico. La administración de corticoides resultó en una mejora significativa del dolor, lo que no solo proporcionó alivio sintomático, sino que también sirvió como un indicativo diagnóstico crucial.
Conclusión: Presentamos el reporte de caso de una paciente femenina con antecedente de lupus eritematoso sistémico que presentaba una afectación multiorgánica con presunto diagnóstico de pancreatitis autoinmune, con difícil control del dolor abdominal que requirió de múltiples terapias analgésicas. La marcada mejoría del dolor con el uso de corticoterapia fue un criterio diagnóstico clave para esta patología. Este caso destaca la importancia de considerar la pancreatitis autoinmune en pacientes con enfermedades autoinmunes y la eficacia de los corticoides en el manejo del dolor asociado a esta condición. La experiencia adquirida con este caso puede ser valiosa para futuros diagnósticos y tratamientos de pacientes con cuadros clínicos similares.





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Instrucciones para citar

Buitrago C, Solarte D, Arce L. Autoimmune pancreatitis in a patient with systemic lupus erythematosus: case report. Rev Soc Esp Dolor 2024; 31(3): 176-179 / DOI: 1020986/resed20254167/2024


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Recibido: 02/08/2024

Aceptado: 04/05/2025

Prepublicado: 21/05/2025

Publicado: 01/10/2025

Tiempo de prepublicación: 292 días

Tiempo de edición del artículo: 425 días


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