{
  "abstract": "A 67-year-old man with type 1 autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis experienced a relapse, while presenting with pancreatic head swelling and distal bile duct stenosis. Despite an increase in the prednisolone dosage (from 7.5 to 20 mg/day), the disease worsened. A significant dilatation of the main pancreatic duct (8 mm) and new stenosis of the pancreatic tail duct were observed. Malignancy was ruled out by repeated endoscopic ultrasound-guided fine-needle aspiration biopsies. A further escalation of the prednisolone dose to 40 mg/day led to clinical and radiological improvements. This case underscores the difficulty in distinguishing a steroid-resistant AIP relapse from pancreatic cancer, and the importance of ruling out malignancy before intensifying immunosuppressive therapy.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "Kenji Hirano"
    },
    {
      "name": "Kanami Kondo"
    },
    {
      "name": "Toshifumi Saito"
    },
    {
      "name": "Keigo Takahashi"
    },
    {
      "name": "Shinji Ono"
    },
    {
      "name": "Sohei Abe"
    },
    {
      "name": "Tomoji Kato"
    },
    {
      "name": "Katsuya Kobayashi"
    },
    {
      "name": "Kenichiro Sekigawa"
    },
    {
      "name": "Hiroshi Mitsui"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4e9rjb5k57wzp.bib",
  "cited_by": 1,
  "doi": "10.2169/internalmedicine.6704-25",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/internalmedicine/65/17/65_6704-25/_article",
  "id": "4e9rjb5k57wzp",
  "issns": [
    "1349-7235",
    "0918-2918"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/internalmedicine/65/17/65_6704-25/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/general"
    ],
    [
      "openalex",
      "2745|IgG4-Related and Inflammatory Diseases"
    ]
  ],
  "openalex": "W7124142180",
  "pdf_url": "https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_6704-25/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4e9rjb5k57wzp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:31Z",
      "native_id": "10.2169/internalmedicine.6704-25",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/internalmedicine/65/17/65_6704-25/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2745|IgG4-Related and Inflammatory Diseases",
      "subfield": "general"
    }
  ],
  "title": "Steroid-resistant Relapse of Autoimmune Pancreatitis with Marked Main Pancreatic Duct Dilatation Mimicking Multifocal Pancreatic Cancer",
  "title_text": "Steroid-resistant Relapse of Autoimmune Pancreatitis with Marked Main Pancreatic Duct Dilatation Mimicking Multifocal Pancreatic Cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:31Z",
  "url": "https://research.draconitic.com/paper/4e9rjb5k57wzp",
  "venue": "Internal Medicine",
  "versions": []
}