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 MutationCystic 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