Pancreas: Genetic & Autoimmune Pancreatitis
Genetic Pancreatitis
Hereditary Pancreatitis
- Autosomal Dominant
- PRSS1 Mutation – Cationic Trypsinogen Gene
- Presentation: Recurrent Acute Pancreatitis in Pediatrics & Chronic Pancreatitis in Adults
- High Risk for Pancreatic CA
- Diagnosis: Genetic Testing
- Treatment: Same as Chronic Pancreatitis
Tropical Pancreatitis
- Autosomal Recessive
- SPINK1 Mutation – Serine Protease Inhibitor Kazal Type 1
- Associated with Eating Cassava Root
- Presentation: Recurrent Acute Pancreatitis in Pediatrics & Chronic Pancreatitis in Adults
- High Risk for Pancreatic CA
- Diagnosis: Genetic Testing
- Treatment: Same as Chronic Pancreatitis
Other Genetic Mutations
- CFTR Mutation – Cystic Fibrosis Transmembrane Conductance Regulator
- CTRC Mutation – Chymotrypsin C
- CLDN2 Mutation
- CPA1 Mutation
Autoimmune Pancreatitis
Types
- Type I: IgG4-Related Disease
- Extrapancreatic Complications: Biliary Stricture, Retroperitoneal Fibrosis & Interstitial Nephritis
- Type II: Not IgG4-Related
- Limited to Pancreas
Diagnosis
- CT: Diffuse Hypoechoic Enlargement & Main Duct Narrowing
- Biopsy: Plasma & Lymphocytic Infiltrate
Treatment
- Primary Treatment: Steroids