• Yuichiro Iwamoto, Fuminori Tatsumi, Kenji Kohara, Masashi Shimoda, Shuhei Nakanishi, Tomoatsu Mune, Kohei Kaku, and Hideaki Kaneto.
• Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan.
• Medicine (Baltimore). 2022 Jan 14; 101 (2): e28609e28609.

IntroductionAutoimmune pancreatitis (AIP) is characterized by the involvement of autoimmune mechanisms and is classified as type 1, together with infiltration of IgG4-positive cells, and type 2 with poor serological abnormal findings. In clinical practice, AIP is often treated with steroid therapy.Patient ConcernsAn 81-year-old Japanese woman had thirst and appetite loss in the previous 5 days; thus, she visited a local doctor. The patient had no abdominal or back pain. She had no history of diabetes mellitus, but at that time blood glucose level and HbA1c were as high as 633 mg/dL and 9.7%, respectively, and she was referred to our institution.DiagnosisBased on various clinical findings in this patient, we diagnosed her with hyperglycemic and hyperosmolar syndrome and depletion of insulin secretory capacity induced by type 2 AIP.Interventions And OutcomesThe patient completely recovered without steroid therapy and was withdrawn from insulin therapy.ConclusionsWe should bear in mind the possibility of AIP when the sudden onset of hyperglycemia together with enlargement of the pancreas are observed in subjects without a history of diabetes mellitus.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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