A Case of Chronic Granulomatous Pancreatitis

We present a 23-year-old woman with a 4-year history of an ambiguous, nonmalignant pancreatic head mass and recurrent nausea/vomiting, right upper quadrant abdominal pain, jaundice, oral feeding intolerance, chronic portal vein thrombosis, and pancytopenia. A multidisciplinary effort with extensive...

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Bibliographic Details
Main Authors: Ethan Angle, Frida Teran-Garza, Alex Paschke, Bradley Manning
Format: Article
Language:English
Published: American College of Physicians 2025-06-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2025.0049
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Summary:We present a 23-year-old woman with a 4-year history of an ambiguous, nonmalignant pancreatic head mass and recurrent nausea/vomiting, right upper quadrant abdominal pain, jaundice, oral feeding intolerance, chronic portal vein thrombosis, and pancytopenia. A multidisciplinary effort with extensive history-taking, laboratory work-up, and repeated endoscopic ultrasound with fine-needle aspiration narrowed her differential diagnosis—which included IgG4-related disease—into the seventh instance of chronic granulomatous pancreatitis secondary to histoplasmosis that has been reported in the literature to our knowledge. The patient remains symptom free on her year-long course of itraconazole, and her satisfactory outcome is an exemplification of the diagnostic and therapeutic power in specialty consultation by hospitalists.
ISSN:2767-7664