Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 168: A 52-Year-Old with Abdominal Pain and an Elevated Lipase
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Oct 16, 2025 Dive into a riveting discussion about pancreatitis, sparked by a case of a 52-year-old man experiencing abdominal pain. The hosts analyze the critical role of risk factors like alcohol and gallstones, complemented by intriguing lab and CT findings. A spotlight on IgG4-related autoimmune pancreatitis reveals its diagnostic challenges and treatment strategies, including glucocorticoids and emerging therapies. Uncover vital insights into how this condition mimics tumors and the importance of awareness for effective diagnosis.
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Patient's Prior Episode And Current Exam
- The patient had a prior presumed pancreatitis episode with ultrasound showing gallbladder wall thickening but no stones.
- He developed chronic abdominal pain, avoided fats, and now presents volume depleted with diffuse tenderness and elevated lipase.
Autoimmune Pancreatitis Mimics Cancer
- The patient's presentation and imaging strongly suggested autoimmune pancreatitis due to IgG4-related disease.
- IgG4-related disease can mimic pancreatic cancer and often presents in middle-aged men with multi-organ involvement.
Protean Multi-Organ Presentation
- IgG4-related disease forms tumefactive lesions and can affect virtually any organ system.
- Many patients have allergic features like atopy, asthma, and nasal polyps that can point toward the diagnosis.
