Autoimmune Pancreatitis in a 9-Year-Old Boy

Introduction: Autoimmune pancreatitis (AIP) is a rare and distinct form of chronic pancreatitis with autoimmune manifestations.The diagnosis of AIP is suggested by a combination of clinical features, imaging modalities of pancreatic parenchyma and ducts, and serology.We present the case of a pediatric male patient with recurrent bouts of painless jaundice.Case: A 9-year-old male patient was admitted to the emergency department with painless jaundice and scleral icterus.Ct scan of the abdomen revealed diffuse enlargement of the pancreas with featureless borders and loss of definition of the pancreatic clefts, revealing a "sausage-like" appearance.Those findings are highly suggestive of Autoimmune Pancreatitis (AIP).Autoimmune serology revealed normal levels of immunoglobulin IgG4 and other immunologic markers.A trial of prednisone for six weeks was initiated and yielded a remarkable resolution of the patient's symptoms. Discussion:The pathophysiology of autoimmune pancreatitis is not well understood in the pediatric age group.Adults usually experience painless obstructive jaundice and weight loss, while children are more likely to present with acute abdominal pain and obstructive jaundice, along with other findings like weight loss, fatigue, and vomiting.In our case, the patient presented an atypical presentation of pediatric AIP with a painless and obstructive pattern of jaundice similar to the adult presentation. Conclusion:Autoimmune pancreatitis is a rare condition, predominantly seen in adults but has also been described in children.Clinicians should keep this disease on the differential in patients presenting with obstructive jaundice.