Case Report
Volume 9 Issue 3 - 2022
Autoimmune Hepatitis-Autoimmune Pancreatitis Association: A Case Report
B Bouibaouen*, H Elbacha, N Benzzoubeir, T Gharbi and I Errabih
Medicine B Department of Gastro-enterology, Ibn Sina Hospital, UHC Ibn Sina, Rabat, Morocco
*Corresponding Author: B Bouibaouen, Medicine B Department of Gastro-enterology, Ibn Sina Hospital, UHC Ibn Sina, Rabat, Morocco.
Received: February 13, 2022; Published: February 28, 2022


Introduction: Autoimmune diseases are the consequence of an immune response against the organism itself, abnormally considered as foreign. We report the clinical case of a patient with an association of two entities: auto-immune pancreatitis and auto-immune hepatitis.

Observation: Mr A.H, 56 years old, with no notable pathological history. He presented in consultation for cholestatic jaundice with intermittent epigastralgia aggravated by meals. Clinical examination revealed conjunctival jaundice with no other abnormalities. The biological work-up revealed cytolysis: ASAT 112, ALAT 30, cholestasis: GGT 745, PAL 838, BT 9. Lipasemia > 3 times the normal value. Abdominal ultrasound returned without abnormality. CT scan (Figure 2) showed a diffuse sausage-like hypertrophy of the pancreas with disappearance of the lobular aspect with a hyporehauled peri-glandular halo without a clearly detectable mass, suggesting a probably autoimmune pancreatitis. The liver was normal, no dilatation of the bile ducts was found. viral serologies (HAV, HCV, HBV) were negative. The serum IgG >1.1 times the upper normal value, the anti-smooth muscle Ac > 1/80. Anatomopathological study of the liver biopsy was compatible with autoimmune hepatitis (Figure 1). The diagnosis of autoimmune hepatitis was retained (diagnostic score = 7) and autoimmune pancreatitis. The patient was put on corticosteroid therapy + azathioprine with good evolution, he was kept under regular follow up.

Conclusion: The diagnosis of AIP and AIH is based on multiples criteria’s and arguments, and the association of these two entities is not usual. However, this association can be evoked in a known patient with autoimmune pancreatitis, who presents symptoms or biological abnormalities suspecting an autoimmune hepatitis.


Keywords: Autoimmune Hepatitis; Autoimmune Pancreatitis


  1. Nahon-Uzan K., et al. “La pancréatite chronique idiopathique est-elle une maladie auto-immune?” Gastroentérologie Clinique et Biologique (2003).
  2. Chari ST., et al. “Diagnosis of autoimmune pancreatitis: The Mayo Clinic experience”. Clinical Gastroenterology and Hepatology 8 (2006): 1010-1016.
  3. Okazaki K., et al. “Diagnosis and classification of autoimmune pancreatitis”. Autoimmunity Reviews 4-5 (2014): 451-458.
  4. Kawamoto S., et al. “Lymphoplasmacytic sclerosing pancreatitis (autoimmune pancreatitis): Evaluation with multidetector CT”. Radiographics 1 (2008): 157-170.
  5. Yamamoto M., et al. “Clinical and pathological characteristics of Mikulicz’s disease (IgG4-related plasmacytic exocrinopathy”. Autoimmunity Reviews 4 (2005): 195-200.
  6. Lee LK., et al. “Autoimmune pancreatitis in the context of IgG4-related disease: review of imaging findings”. World Journal of Gastroenterology 41 (2014): 15177-15189.
  7. Tang CSW., et al. “Abdominal manifestations of IgG4- related disease: a pictorial review”. Insights Imaging4 (2018): 437-448.
  8. Hafezi-Nejad N., et al. “MR imaging of autoimmune pancreatitis”. Magnetic Resonance Imaging Clinics of North America 3 (2018): 463-478.
  9. Kim JH., et al. “Atypical manifestation of IgG4 related sclerosing disease of the abdomen: Imaging findings and pathologic correlation”. American Journal of Roentgenology 1 (2013): 102-112.
  10. Sánchez-Castanon M., et al. “Autoimmune pancreatitis: an underdiagnosed autoimmune disease with clinical, imaging and serological features”. Autoimmunity Reviews 4 (2010): 237-240.
  11. Brito-Zeron P., et al. “The clinical spectrum of IgG4-related disease”. Autoimmunity Reviews 12 (2014): 1203-1210.
  12. Islam AD., et al. “The changing faces of IgG4- related disease: Clinical manifestations and pathogenesis”. Autoimmunity Reviews 10 (2015): 914-922.
  13. Reuben A. “A sheep in wolf’s clothing”. Hepatology6 (2003): 1596-1601.
  14. Johnson PJ and McFarlane IG. “Meeting report: International Autoimmune Hepatitis Group”. Hepatology 4 (1993): 998-1005.
  15. Gleeson D., et al. “British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis”. Gut 12 (2011): 1611-1629.
  16. Longhi MS., et al. “Aetiopathogenesis of autoimmune hepatitis”. Journal of Autoimmunity 1 (2010): 7-14.
  17. Kogan J., et al. “Prognosis of symptomatic versus asymptomatic autoimmune hepatitis: A study of 68 patients”. Journal of Clinical Gastroenterology 1 (2002): 75-81.
  18. Krawitt EL. “Autoimmune hepatitis”. New England Journal of Medicine 1 (2006): 54-66.
  19. Czaja AJ. “The overlap syndromes of autoimmune hepatitis”. Digestive Diseases and Sciences 2 (2013): 326-343.
  20. Boberg KM., et al. “Overlap syndromes: The International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue”. Journal of Hepatology 2 (2011): 374-385.
  21. Werner M., et al. “Epidemiology and the initial presentation of autoimmune hepatitis in Sweden: A nationwide study”. Scandinavian Journal of Gastroenterology 10 (2008): 1232-1240.
  22. Muratori P., et al. “Autoimmune hepatitis in Italy: the Bologna experience”. Journal of Hepatology 6 (2009): 1210-1218.
  23. Hennes EM., et al. “Simplified criteria for the diagnosis of autoimmune hepatitis”. Hepatology1 (2008): 169-176.
  24. Czaja AJ., et al. “Advances in the diagnosis, pathogenesis, and management of autoimmune hepatitis”. Gastroenterology 1 (2010): 58-72.
  25. Corpéchot C., et al. “Hépatites auto-immunes: actualités diagnostiques et thérapeutiques”. La Revue de Medecine Interne 9 (2010): 606-614.
  26. De Andrade LV., et al. “Autoimmune pancreatitis and hepatitis: an uncommon association”. The American Journal of Gastroenterology9 (2000): 2391-2394.
Citation: B Bouibaouen., et al. “Autoimmune Hepatitis-Autoimmune Pancreatitis Association: A Case Report”. EC Gastroenterology and Digestive System 9.3 (2022): 42-47.

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