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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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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author Ethan Angle
Frida Teran-Garza
Alex Paschke
Bradley Manning
author_facet Ethan Angle
Frida Teran-Garza
Alex Paschke
Bradley Manning
author_sort Ethan Angle
collection DOAJ
description 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.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-262d8fd95ef149c3a9ef40a04376cb162025-08-20T03:19:20ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-06-014610.7326/aimcc.2025.0049A Case of Chronic Granulomatous PancreatitisEthan Angle0Frida Teran-Garza1Alex Paschke2Bradley Manning31Carver College of Medicine, University of Iowa, Iowa City, Iowa2Department of Internal Medicine, University of Iowa Health Care Medical Center, Iowa City, Iowa2Department of Internal Medicine, University of Iowa Health Care Medical Center, Iowa City, Iowa2Department of Internal Medicine, University of Iowa Health Care Medical Center, Iowa City, IowaWe 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.https://www.acpjournals.org/doi/10.7326/aimcc.2025.0049
spellingShingle Ethan Angle
Frida Teran-Garza
Alex Paschke
Bradley Manning
A Case of Chronic Granulomatous Pancreatitis
Annals of Internal Medicine: Clinical Cases
title A Case of Chronic Granulomatous Pancreatitis
title_full A Case of Chronic Granulomatous Pancreatitis
title_fullStr A Case of Chronic Granulomatous Pancreatitis
title_full_unstemmed A Case of Chronic Granulomatous Pancreatitis
title_short A Case of Chronic Granulomatous Pancreatitis
title_sort case of chronic granulomatous pancreatitis
url https://www.acpjournals.org/doi/10.7326/aimcc.2025.0049
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