Interstitial pneumonia associated with autoimmune pancreatitis

We read with interest the article by Kamisawa et al reporting IgG4 positive plasma cells in peripancreatic tissue, extrahepatic bile duct, gall bladder, and salivary gland ( Gut 2003; 52 :683–7). The association of retroperitoneal fibrosis and sclerosing pancreatitis with IgG4 bearing plasma cells in the tissues of both lesions has been also reported.1 We would like to report the first case of interstitial pneumonia associated with autoimmune pancreatitis and IgG4 positive plasma cells in the intersitium. Hyperamylasemia was detected in a routine blood examination in a 63 year old man who had been treated for duodenal ulcer at a clinic. He was admitted to our hospital for further examination. He did not complain of epigastralgia or back pain. Serum amylase was 323 (39–130 IU/l), IgG was elevated to 2350 (800~1600 mg/dl), and IgG4 was 1690 (<80 mg/dl). Antinuclear antibody, anti-SS-A antibody, anti-SS-B antibody, rheumatoid factor, and antismooth muscle antibody were all negative. Abdominal ultrasonography and computed tomography (CT) showed …