Autoimmune pancreatitis: A review

Zandieh, Iman

doi:10.3748/wjg.13.6327

Cited by 14 publications

(22 citation statements)

References 21 publications

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“…There are various case reports on renal involvement in patients with AIP [7, 12, 13, 20]. Takahashi et al [13] described small peripheral cortical nodules or diffuse patchy areas in renal parenchyma suggestive of renal involvement on CT or MRI in 35% of a group of 40 patients with AIP which regressed after corticosteroid treatment.…”

Section: Clinical Presentations Of Igg4-related Systemic Diseasementioning

confidence: 99%

“…The histopathological hallmark in AIP is the presence of abundant IgG4-positive plasma cells [6, 10, 16, 20, 21, 35]. In up to 100% of AIP cases, >10 IgG4-positive cells/HPF can be seen, in both excision and biopsy specimen of the pancreas [5, 17, 21, 36], even in the absence of elevated serum IgG4 [22].…”

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

“…Pancreatic parenchymal calcifications vary between 8 and 14% [21, 24], while pancreatic cysts are rare in AIP [10, 24]. Classical AIP findings in ERCP are focal, segmental, or diffuse narrowing of the main pancreatic duct, although many variations exist, depending on the course of disease [6, 8, 12, 20, 23, 24]. On EUS, typically, a hypo-echoic gland with focal or diffuse parenchymal swelling can be seen [20].…”

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

“…Classical AIP findings in ERCP are focal, segmental, or diffuse narrowing of the main pancreatic duct, although many variations exist, depending on the course of disease [6, 8, 12, 20, 23, 24]. On EUS, typically, a hypo-echoic gland with focal or diffuse parenchymal swelling can be seen [20]. Fluorodeoxyglucose positron emission tomography (FDG-PET) revealed FDG uptake in the pancreas in AIP patients [16, 33] that disappeared after corticosteroid treatment in a small study with 6 patients [34].…”

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

“…AIP (as part of ISD) is a disease of elderly men, with average age consistently reported around 65 years, with a male predilection of 80%. The prevalence of AIP or ISD is largely unknown, although retrospective series report AIP in 4 to 6% of patients with chronic pancreatitis [20]. Main presenting symptoms are obstructive jaundice (around 70%; due to intrapancreatic biliary obstruction or IgG4-associated sclerosing cholangitis), diabetes mellitus (around 40–60%), weight loss and mild abdominal pain (≥30%, each) [6, 8,10,11,12,13, 15, 16, 18,20,21,22,23].…”

Section: Clinical Presentations Of Igg4-related Systemic Diseasementioning

confidence: 99%

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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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Section: Clinical Presentations Of Igg4-related Systemic Diseasementioning

confidence: 99%

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

Section: Diagnosis Of Isd and Its Organ Manifestationsmentioning

confidence: 99%

Section: Clinical Presentations Of Igg4-related Systemic Diseasementioning

confidence: 99%

See 3 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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Acute pancreatitis

Munsell

Buscaglia

2010

Journal of Hospital Medicine

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Acute pancreatitis is a common disease most frequently caused by gallstone disease or excess alcohol ingestion. Diagnosis is usually based on characteristic symptoms, often in conjunction with elevated serum pancreatic enzymes. Imaging is not always necessary, but may be performed for many reasons, such as to confirm a diagnosis of pancreatitis, rule out other causes of abdominal pain, elucidate the cause of pancreatitis, or to evaluate for complications such as necrosis or pseudocysts. Though the majority of patients will have mild, self‐limiting disease, some will develop severe disease associated with organ failure. These patients are at risk to develop complications from ongoing pancreatic inflammation such as pancreatic necrosis, fluid collections, pseudocysts, and pancreatic duct disruption. Validated scoring systems can help predict the severity of pancreatitis, and thus, guide monitoring and intervention.Treatment of acute pancreatitis involves supportive care with fluid replacement, pain control, and controlled initiation of regular food intake. Prophylactic antibiotics are not recommended in acute pancreatitis if there is no evidence of pancreatic infection. In patients who fail to improve, further evaluation is necessary to assess for complications that require intervention such as pseudocysts or pancreatic necrosis. Endoscopy, including ERCP and EUS, and/or cholecystectomy may be indicated in the appropriate clinical setting. Ultimately, the management of the patient with severe acute pancreatitis will require a multidisciplinary approach. Journal of Hospital Medicine 2010;5:241–250. © 2010 Society of Hospital Medicine.

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