Diagnostic and therapeutic considerations in biopsy‐proven type 2 autoimmune pancreatitis: comparative analysis with biopsy‐proven type 1 autoimmune pancreatitis

2020 ◽  
Author(s):  
Krishna Pattabathula ◽  
Peadar S. Waters ◽  
Jason Hwang ◽  
Mark Bettington ◽  
Mahendra Singh ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Autoimmune Pancreatitis ◽  
Type 1 Autoimmune Pancreatitis ◽  
Therapeutic Considerations

scholarly journals Pancreatitis autoinmune. Serie de casos y actualización bibliográfica

2021 ◽  
Vol 51 (3) ◽  
Author(s):  
Analia Verónica Pasqua ◽  
Juan Carlos Spina ◽  
Eduardo Mullen
Keyword(s):  
Autoimmune Pancreatitis ◽  
Case Reports ◽  
Pancreatic Disease ◽  
Histological Evaluation ◽  
First Case ◽  
Type 1 Autoimmune Pancreatitis ◽  
Pancreatic Disorders ◽  
The 1960S

The concept and diagnostic criteria for autoimmune pancreatitis have evolved since the first case reports published in the 1960s. The advances in knowledge during the past two decades have resulted in the recognition of several pancreatic conditions that show, on histological evaluation, variable combinations of inflammation and fibrosis. In fact, autoimmune pancreatitis comprises two distinct diseases: type 1 and type 2. Type 2 autoimmune pancreatitis is a particular pancreatic disease about which there is limited data; it differs from the ‘classic’ IgG4-related type 1 autoimmune pancreatitis in terms of epidemiology, pathological characteristics and natural evolution. There are patients with complex pancreatic conditions where an autoimmune component and good response to steroids are demonstrated, but they do not meet the suggested criteria for the diagnosis of type 1 or type 2 autoimmune pancreatitis. Although the term steroid-responsive pancreatitis may be interpreted as a synonym to type 1 and 2 autoimmune pancreatitis, these are not the only pancreatic conditions that improve with this type of treatment. Here, we present three clinical cases and a literature review related to the diagnosis and treatment of autoimmune pancreatitis and other less frequent pancreatic disorders that present a good response to steroid therapy.

Clinical features and relapse rates after surgery in type 1 autoimmune pancreatitis differ from type 2: A study of 114 surgically treated European patients

Pancreatology ◽  
2012 ◽  
Vol 12 (3) ◽  
pp. 276-283 ◽  
Author(s):  
Sönke Detlefsen ◽  
Giuseppe Zamboni ◽  
Luca Frulloni ◽  
Bernd Feyerabend ◽  
Felix Braun ◽  
...  
Keyword(s):  
Clinical Features ◽  
Autoimmune Pancreatitis ◽  
Type 1 Autoimmune Pancreatitis ◽  
Relapse Rates

scholarly journals Sex-Related Differences of Acute and Chronic Pancreatitis in Adults

2021 ◽  
Vol 10 (2) ◽  
pp. 300
Author(s):  
Madeline Drake ◽  
Shah-Jahan M. Dodwad ◽  
Joy Davis ◽  
Lillian S. Kao ◽  
Yanna Cao ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
The United States ◽  
Prevention Strategies ◽  
Endoscopic Retrograde ◽  
Effective Prevention ◽  
Type 1 Autoimmune Pancreatitis ◽  
Acute And Chronic Pancreatitis ◽  
Effective Prevention Strategies

The incidence of acute and chronic pancreatitis is increasing in the United States. Rates of acute pancreatitis (AP) are similar in both sexes, but chronic pancreatitis (CP) is more common in males. When stratified by etiology, women have higher rates of gallstone AP, while men have higher rates of alcohol- and tobacco-related AP and CP, hypercalcemic AP, hypertriglyceridemic AP, malignancy-related AP, and type 1 autoimmune pancreatitis (AIP). No significant sex-related differences have been reported in medication-induced AP or type 2 AIP. Whether post-endoscopic retrograde cholangiopancreatography pancreatitis is sex-associated remains controversial. Animal models have demonstrated sex-related differences in the rates of induction and severity of AP, CP, and AIP. Animal and human studies have suggested that a combination of risk factor profiles, as well as genes, may be responsible for the observed differences. More investigation into the sex-related differences of AP and CP is desired in order to improve clinical management by developing effective prevention strategies, diagnostics, and therapeutics.

Serum and histological IgG4-negative type 1 autoimmune pancreatitis

2018 ◽  
Vol 12 (3) ◽  
pp. 232-238 ◽  
Author(s):  
Yuichi Takano ◽  
Takahiro Kobayashi ◽  
Fumitaka Niiya ◽  
Eiichi Yamamura ◽  
Naotaka Maruoka ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Negative Type ◽  
Type 1 Autoimmune Pancreatitis

scholarly journals Type 1 autoimmune pancreatitis

2011 ◽  
Vol 6 (1) ◽  
pp. 82 ◽  
Author(s):  
Yoh Zen ◽  
Dimitrios P Bogdanos ◽  
Shigeyuki Kawa
Keyword(s):  
Autoimmune Pancreatitis ◽  
Type 1 Autoimmune Pancreatitis

Recent advances in autoimmune pancreatitis: type 1 and type 2

Gut ◽  
2013 ◽  
Vol 62 (9) ◽  
pp. 1373-1380 ◽  
Author(s):  
Terumi Kamisawa ◽  
Suresh T Chari ◽  
Markus M Lerch ◽  
Myung-Hwan Kim ◽  
Thomas M Gress ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Recent Advances

Clinical Evaluation of International Consensus Diagnostic Criteria for Type 1 Autoimmune Pancreatitis in Comparison With Japanese Diagnostic Criteria 2011

Pancreas ◽  
2013 ◽  
Vol 42 (8) ◽  
pp. 1238-1244 ◽  
Author(s):  
Itaru Naitoh ◽  
Takahiro Nakazawa ◽  
Kazuki Hayashi ◽  
Katsuyuki Miyabe ◽  
Shuya Shimizu ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Evaluation ◽  
Autoimmune Pancreatitis ◽  
International Consensus ◽  
Type 1 Autoimmune Pancreatitis

Autoimmune Pancreatitis

2018 ◽  
Author(s):  
Allison L Yang ◽  
Julia McNabb-Baltar
Keyword(s):  
Chronic Pancreatitis ◽  
Obstructive Jaundice ◽  
Autoimmune Pancreatitis ◽  
Pancreatic Insufficiency ◽  
Imaging Findings ◽  
Laboratory Findings ◽  
Related Disease

Autoimmune pancreatitis (AIP) is a subcategory of chronic pancreatitis that is highly responsive to steroids. The term was first proposed in 1995 by Yoshida and colleagues, and since its discovery, the diagnosis of AIP has dramatically increased. AIP is a chronic fibroinflammatory disease characterized by lymphoplasmacytic infiltrates and fibrosis on histology. There are two distinct subtypes: type 1 AIP is the pancreatic manifestation of a systemic serum immunoglobulin G subtype 4–related disease (IgG4-RD) and type 2 AIP is described clinically as idiopathic duct-centric pancreatitis and has no association with IgG4. Clinically, AIP presents most commonly as obstructive jaundice in type 1 AIP and can present as acute pancreatitis in type 2 AIP. The diagnostic criteria include histology, imaging findings, and responsiveness to steroids as well as laboratory findings and other organ involvement. The mainstay of treatment is steroid therapy, with immunomodulators such as rituximab used for maintenance or relapsing disease. Long-term complications of AIP include pancreatic insufficiency and are often associated with relapsing disease. This review contains 45 references, 1 figure, and 2 tables. Key Words: autoimmune pancreatitis, chronic pancreatitis, EUS-guided biopsy, IgG4, immunomodulatory, obstructive jaundice, pancreas mass, steroid

Surgery in autoimmune pancreatitis

2021 ◽  
Author(s):  
Sara Nikolic ◽  
Poya Ghorbani ◽  
Raffaella Pozzi Mucelli ◽  
Sam Ghazi ◽  
Francisco Baldaque- Silva ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
University Hospital ◽  
Premalignant Lesions ◽  
Single Centre ◽  
Age At Surgery ◽  
Diagnostic Work ◽  
Work Up

Introduction: Autoimmune pancreatitis (AIP) is a disease that may mimic malignant pancreatic lesions both in terms of symptomatology and imaging appearance. The aim of the present study is to analyse experiences of surgery in patients with AIP in one of the largest European cohorts. Methods: We performed a single-centre retrospective study of patients diagnosed with AIP at the Department of Abdominal Diseases at Karolinska University Hospital in Stockholm, Sweden, between January 2001 and October 2020. Results: There were 159 patients diagnosed with AIP, and among them 35 (22.0%) patients had surgery: 20 (57.1%) males and 15 (42.9%) females; average age at surgery was 59 years (range 37-81). Follow-up period after surgery was 67 months (range 1-235). AIP type 1 was diagnosed in 28 (80%) patients and AIP type 2 in 7 (20%) patients. Malignant and premalignant lesions were diagnosed in 8 (22.9%) patients for whom AIP was not the primary differential diagnosis but, in all cases, it was described as a simultaneous finding and recorded in retrospective analysis in histological reports of surgical specimens. Conclusions: Diagnosis of AIP is not always straightforward, and, in some cases, it is not easy to differentiate it from the malignancy. Surgery is generally not indicated for AIP but might be considered in patients when suspicion of malignant/premalignant lesions cannot be excluded after complete diagnostic work-up.

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