A new diagnostic endoscopic tool for autoimmune pancreatitis

Kamisawa, Terumi; Tu, Yifeng; Egawa, Naoto; Tsuruta, Kouji; Okamoto, Akira

doi:10.1016/j.gie.2008.02.018

Cited by 85 publications

(63 citation statements)

References 11 publications

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“…Additional studies revealed that microscopic findings with immunohistochemistry of the major papilla could support the diagnosis of AIP [10,11]. This article reviews the literature published about the major papilla in AIP and our observations.…”

Section: Introductionmentioning

confidence: 56%

Major Duodenal Papilla in Autoimmune Pancreatitis

2010

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Autoimmune pancreatitis (AIP) is a distinctive form of chronic pancreatitis that can mimic pancreatobiliary malignancies. If AIP is properly diagnosed, it can be treated without laparotomy or pancreatic resection due to its dramatic response to steroid therapy. In addition to elevated serum IgG4 levels, IgG4 immunostaining of involved tissue is often used to support the diagnosis of AIP. The major duodenal papilla is a conduit between the duodenum and the pancreatobiliary system and occasionally reflects underlying pancreatobiliary disorders. Previous studies demonstrated that IgG4-positive lymphoplasmacytic infiltration was detected in the major duodenal papilla in connection to the pancreatic head in patients with AIP, and IgG4 immunostaining of biopsy specimens obtained from the major papilla could support a preoperative diagnosis of AIP. This review discusses macro- and microscopic findings of the major duodenal papilla of AIP patients, especially focusing on the diagnostic value of IgG4 immunostaining of duodenal papillary biopsy specimens.

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Section: Introductionmentioning

confidence: 56%

Major Duodenal Papilla in Autoimmune Pancreatitis

2010

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“…The concept of an ISD has since then been confirmed by many reports on multiorgan inflammatory, mass-forming lesions, sharing typical histological features and corticosteroid-responsiveness [6,7,8,9,10,11] now considered characteristic of ISD.…”

Section: Concept Of Igg4-related Systemic Diseasementioning

confidence: 90%

“…Because imaging features in AIP can also typically mimic pancreatic cancer, as discussed later, it is not surprising that up to a third of AIP patients are diagnosed after major surgery for suspected malignancy [8, 23, 24]. In North America, about 2.5% of all pancreatoduodenectomy specimens revealed histological signs of AIP after surgery [9]. Fortunately, increasing awareness for AIP may have contributed to a recent decline in the number of patients diagnosed with AIP only after major surgery [8].…”

Section: Clinical Presentations Of Igg4-related Systemic Diseasementioning

confidence: 99%

“…A classical finding in AIP is the diffusely enlarged relatively hypodense ‘sausage-like’ pancreas, with delayed enhancement of the pancreatic parenchyma on imaging (CT or MRI). Mild peri-pancreatic lymphadenopathy is commonly seen [5,9,10,11, 16, 17, 27, 31], whereas peri-pancreatic fat infiltration is uncommon. Pancreatic parenchymal calcifications vary between 8 and 14% [21, 24], while pancreatic cysts are rare in AIP [10, 24].…”

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

“…Increasing awareness of ISD and detection of more sensitive and specific markers for diagnosing ISD may contribute to improve the diagnostic yield for AIP and ISD in the near future [7, 9, 10, 12, 20, 21, 23, 24]. …”

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

See 2 more Smart Citations

Immunoglobulin G4-Associated Cholangitis: One Variant of Immunoglobulin G4-Related Systemic Disease

Alderlieste

Elzen²,

Rauws³

et al. 2009

Digestion

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IgG4-associated cholangitis (IAC) is a recently defined disease entity which shares a number of clinical, biochemical, and radiological features with primary sclerosing cholangitis (PSC). In contrast to PSC, IAC responds to immunosuppressive treatment, is not associated with inflammatory bowel disease, and mainly affects elderly men above the age of 60 years. Today, IAC is regarded as one variant of IgG4-related systemic disease (ISD) of which autoimmune pancreatitis (AIP) is the best studied organ manifestation. The diagnosis of IAC is based on biochemical, radiological and histologic features, among which elevated serum levels of IgG4, extra- and intrahepatic biliary strictures as visualized by cholangiography, multifocal IgG4-rich lymphoplasmacytic sclerosing infiltrations in liver and bile duct tissue, and association with AIP are of key importance. This review aims at summarizing clinical features, diagnostic criteria, therapeutic strategies and most recent insights in the pathophysiology of IAC and other organ manifestations of ISD.

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Autoimmune Pancreatitis: How to Recognize This Entity and Avoid Surgical Treatment

Sah

Chari

2015

Pancreatic Cancer, Cystic Neoplasms and Endocrine Tumors

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A new diagnostic endoscopic tool for autoimmune pancreatitis

Cited by 85 publications

References 11 publications

Major Duodenal Papilla in Autoimmune Pancreatitis

Major Duodenal Papilla in Autoimmune Pancreatitis

Immunoglobulin G4-Associated Cholangitis: One Variant of Immunoglobulin G4-Related Systemic Disease

Autoimmune Pancreatitis: How to Recognize This Entity and Avoid Surgical Treatment

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