CASE REPORT - A case of idiopathic pancreatitis in a patient with Crohn's disease

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Korean J Gastroenterol. 2009 Apr;53(4):251-6.

[A case of idiopathic pancreatitis in a patient with Crohn's disease].

[Article in Korean]

Park CB, Moon W, Choi PR, Im DH, Shin EK, Kim KJ, Park MI, Park SJ.

Department of Internal Medicine, Kosin University College of Medicine,

Busan, Korea.

Abstract

Pancreatitis has been occasionally associated with Crohn's disease

(CD). A definite etiology of pancreatitis can be identified in most

patients, but a very small proportion remain idiopathic. We report a

case of idiopathic pancreatitis resolved along with the clinical

improvement of CD in a 25-year-old man. He presented with abdominal

pain and diarrhea for 8 years. Ileocolonoscopy and enteroclysis showed

multiple, longitudinal ulcers and strictures at the ileojejunum. The

laboratory findings showed elevated serum amylase (951 IU/L) and

lipase (326 IU/L) without positive autoantibodies.

Esophagogastroduodenoscopy, enhanced pancreatic CT, and MRCP showed no

abnormalities at ampulla of Vater, pancrease, and pancreaticobiliary

duct. With the treatment with antibiotics, 5-aminosalicylic acid,

steroid, and azathioprine, as a whole, decreasing pattern and

intermittent fine coordinated fluctuation of the levels of amylase and

lipase along with the decrease of Crohn's disease activity index

(CDAI) and the CRP levels were observed. Then, three months after the

start of the treatment, normalization of the pancreatic enzymes was

observed, and there was recurrent elevation of pancreatic engyme

during 12 months maintenance therapy. This report supports the concept

of an association between idiopathic pancreatitis and CD, based on a

significant and close relation between the levels of serum amylase and

lipase, and CDAI.

PMID: 19381059

http://www.ncbi.nlm.nih.gov/pubmed/19381059

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