자가면역성 췌장염은 췌장 실질의 종대 및 주췌관의 불규칙한 협착을 특징으로 하는 질환으로 췌석의 형성을 포함한 췌장 실질의 석회화는 관찰되지 않는 것으로 알려져 왔으나 저자들은 재발의 경과를 거치면서 췌장실질의 석회화와 주체관에 췌석이 형성된 자가면역성췌장염의 증례를 보고하는 바이다. 국내에서 자가면역성췌장염 환자가 증가하면서 다양한 임상양상이 보고되고 있으며, 일반적인 만성 췌장염이나 췌장암과 구별되는 자가면역성 췌장염에 대한 폭넓은 이해를 바탕으로 자가면역성 췌장염의 영상 진단에 새로운 접근이 시도되어야 할 것으로 생각한다.

We report here on a case of autoimmune pancreatitis with pancreaticoliths and multiple parenchymal calcifications, and these do not usually occur in patients with ordinary chronic pancreatitis. A 51-year-old woman was referred to our hospital because of her recent onset diabetes mellitus and abnormally appearing pancreas on CT. Based on the increased serum levels of Ig G and Ig G4, the positive rheumatoid factor and the characteristic findings on abdominal CT and ERCP, the patient was diagnosed with autoimmune pancreatitis, and she was treated with oral corticosteroids. After 2-month administration of prednisolone, CT and ERCP demonstrated a markedly improved pancreas and narrowing of the main pancreatic duct. After 1.5 years, the patient was readmitted because of a recurrent attack of autoimmune pancreatitis. Abdominal CT showed formation of parenchymal calcifications and pancreaticoliths and ERCP revealed pancreaticoliths. We suggest that autoimmune pancreatitis has a potential to be progressive, with parenchymal calcifications and pancreaticoliths, the same as ordinary chronic pancreatitis.(Korean J Med 73:81-85, 2007)