The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. Making the correct diagnosis and differentiating the disease from pancreatic cancer is of the utmost importance. With increased recognition of the concept of autoimmune pancreatitis aip and with the development of diagnostic criteria, the number of aip patients in japan has increased rapidly. Although the pathogenesis of aip remains unclear, an immunemediated mechanism has been postulated. It can be initiated by several factors, including gallstones, alcohol, trauma, infections and hereditary factors. Type 1 autoimmune pancreatitis aip is the pancreatic manifestation of a multiorgan disease, named immunoglobulin g4 igg4related disease while type 2 aip is a pancreas specific disorder not associated with igg4. Pancreatitis 1 especialidades medicas medicina clinica. To retrospectively determine imaging findings in patients with autoimmune pancreatitis.
G yoshida 1995 propose concept of autoimmune pancreatitishamano 1995 increased serum levels of igg4 in aip jps 2002 japan pancreas society. Each year, about 210,000 people in the united states are admitted to the hospital with acute pancreatitis. Recent advances in the diagnosis and management of. Epidemiology of autoimmune pancreatitis the pancreas. Clinical differences between massforming autoimmune pancreatitis and pancreatic cancer. Pancreatitis autoinmune gastroenterologia y hepatologia. Type 1 autoimmune pancreatitis aip is a distinctive type of pancreatitis characterized by the diffuse irregular narrowing of the main pancreatic duct, sausagelike. History of autoimmune pancreatitis sarle 1961 idiopathic chronic pancreatitis with elevated. Download fulltext pdf download fulltext pdf autoantibodies in autoimmune pancreatitis article pdf available in international journal of rheumatology 2012 5. The remission rate for induction treatment with steroids is essentially 100%, and steroids remain highly effective when used for treating disease relapses. Objective autoimmune pancreatitis aip is a treatable form of chronic pancreatitis that has been.
It is associated with ibd but has no known serologic biomarker. Pdf r e v i s i o n e s medicina intensiva pancreatitis. Objective autoimmune pancreatitis aip is a treatable form of chronic pancreatitis that has been increasingly recognised over the last decade. This type is more common in younger people of western european and american ethnicity, does not show a sex predilection, and rarely recurs.
Pdf current perspectives on autoimmune pancreatitis and igg4. Autoimmune pancreatitis is a special form of chronic pancreatitis. Localized autoimmune pancreatitis mimicking pancreatic cancer. Immunomodulators and rituximab in the management of. Type 1 aip is now regarded as a manifestation of igg4related disease, and those. Autoimmune pancreatitis aip is a unique form of chronic pancreatitis that is characterized by a dramatic response to steroid therapy. It is a condition that arises suddenly and may be quite severe, although patients usually have a. Eus in the diagnosis of autoimmune pancreatitis pancreapedia. Autoimmune pancreatitis aip is an unusual etiology of chronic pancreatitis, involved in approximately 6% of. The role of endoscopy in the diagnosis of autoimmune pancreatitis.
Autoimmune pancreatitis aip 1 is a benign fibroinflammatory disease that frequently presents as obstructive jaundice, which may or may not be associated with a pancreatic mass. Review of the diagnosis, classification and management of. Autoimmune pancreatitis is an increasingly recognized type of chronic pancreatitis that can be difficult to distinguish from pancreatic carcinoma but which responds to treatment with corticosteroids, particularly prednisone. Pdf autoimmune pancreatitis aip is a benign, igg4related, fibroinflammatory. R e v i s i o n e s medicina intensiva pancreatitis aguda.
Naitoh i, nakazawa t, hayashi k, okumura f, miyabe k, shimizu s, kondo h, yoshida m, yamashita h, ohara h, and joh t. Mayor incidencia en japn asociada a otros trastornos inmunolgicos. Forsmark division of gastroenterology, hepatology, and nutrition, university of florida, gainesville, florida advances in our understanding of chronic pancreatitis have improved our care of patients with this. Autoimmune pancreatitis aip is a rare, heterogeneous, fibroinflammatory disorder of the pancreas. It was presumed that repeated acute pancreatitis and chronic pancreatitis, especially with a family history of pancreatic disease, may have a. Autoimmune pancreatitis aip is a distinct type of chronic pancreatitis that reportedly occurs in 7% of chronic pancreatitis cases and typically affects patients without a history of alcohol abuse, biliary stone disease, or duodenal wall inflammation 1 5. Acute pancreatitis can be a lifethreatening illness with severe complications. It has gained increasing recognition due to a presentation that can mimic difficulttotreat disorders such as pancreatic cancer, cholangiocarcinoma and primary sclerosing cholangitis. The estimated number of aip patients was 900 in the first japanese nationwide survey conducted in 2002, and it was 2790 in 2007, which was 3.
We set out to better understand the current burden of aip at several academic institutions diagnosed using the international consensus diagnostic criteria, and to describe longterm outcomes, including organs involved, treatments, relapse frequency and. However, in a considerable number of individuals, even many attacks of gallstones and multiple episodes of alcohol abuse do not lead to acute pancreatitis 2, 3. Management of chronic pancreatitis gastroenterology. Autoimmune pancreatitis is a rare type of chronic pancreatitis characterized by fibrosis with abundant infiltration of igg4positive plasma cells and lymphocytes and. Acute pancreatitis affects about 50,000 80,000 americans each year. About 75% of pancreatitis is caused by gallstones or alcohol. This poster was originally presented at the seram 2012 meeting, may 2428, in granadaes. The most frequent causes of acute pancreatitis ap are gallstones and alcohol. Acute pancreatitis is an inflammatory disease of the pancreas.
Diagnosis of autoimmune pancreatitis by eusfna by using a 22gauge needle based on the international consensus diagnostic criteria. Strategy to differentiate autoimmune pancreatitis from pancreas cancer. Pdf igg4related disease igg4rd is a fibroinflammatory disorder recognized as a. Pancreatitis is an uncommon disease characterized by inflammation of the pancreas. Chronic pancreatitis medical expert as medical experts, physicians integrate all of the canmeds roles, applying medical knowledge, clinical skills, and professional attitudes in their provision of patientcentered care. It shows characteristic histological changes, and there is excellent response to corticosteroid therapy, as published in the 2011 international consensus on aip.
Igg4related sclerosing disease chari 2010 two distinct. Type 1 and type 2, each with distinct clinical profiles. Extracellular vesicles microrna analysis in type 1 autoimmune. Request pdf pancreatitis autoinmune autoimmune pancreatitis is a benign fibroinflammatory disease of the pancreas of probable autoimmune origin, which includes 2 different. Autoimmune pancreatitis aip is an immunemediated tumefactive fibroinflammatory disorder that primarily affects the pancreas.
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