Autoimmune Pancreatitis: Differences Between the Focal and Diffuse Forms in 87 Patients

Frulloni, Luca; Scattolini, C.; Falconi, Massimo; Zamboni, Giuseppe; Capelli, Paola; Manfredi, Riccardo; Graziani, Rossella; D’Onofrio, Mirko; Katsotourchi, A.; Amodio, Antonio; Benini, Luigi; Vantini, Italo

doi:10.1038/ajg.2009.327

Cited by 223 publications

(158 citation statements)

References 39 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…autoimmune pancreatitis [7][8][9][10], paraduodenal pancreatitis [11,12], and pancreatitis associated with gene mutations [11,[13][14][15]. However, nowadays there is no international agreement about their definition and/or management.…”

Section: Introductionmentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

Self Cite

166

112

View full text Add to dashboard Cite

This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

show abstract

Section: Introductionmentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

Self Cite

166

112

View full text Add to dashboard Cite

show abstract

“…(Tables 1, 2 and 5). Type 1 AIP frequently occurs in elderly men and is geographically distributed in greater numbers in Asia [29,30] than in western countries [19,20,22,31] . Type 1 AIP is the pancreatic manifestation of IgG4-related disease (IgG4-RD) [23,32] ; consequently, a variety of systemic lesions with IgG4-positive cells infiltrates develop simultaneously or metachronously, in association with elevated level of serum IgG or IgG4 (> 135 mg/dl) and positive serum autoantibodies.…”

Section: Classification Of Aipmentioning

confidence: 99%

“…During this period, the concepts of AIP were well recognized worldwide and nationwide diagnostic criteria were proposed in South Korea [17,18] , the United States, Germany [19] , and Italy [20] . The conditions and methodologies used in each criterion varied; hence, the cases diagnosed as AIP sometimes differed by country.…”

Section: Topic Highlightmentioning

confidence: 99%

“…Diagnostic criteria, either nationwide [9,[16][17][18][19][20] or international [24,25] , consist mostly of common diagnostic items such as image findings of the pancreatic parenchyma, pancreatography, and extrapancreatic lesions; serological findings; histology of the pancreatic lesion; and response to steroid therapy (Tables 1-3). The diagnostic items are very similar, but the method or approach for analyzing each finding varies depending on the country.…”

Section: Diagnostic Criteria Of Aipmentioning

confidence: 99%

“…In contrast, the Mayo Clinic in the United States [9] routinely performs pancreatic core biopsy for diagnosing AIP. These differences in the methodology seem to reflect the diagnostic criteria or diagnostic algorithm used by individual country [9,[16][17][18][19][20] .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis Autoimmune Pancreatitis

Hart¹,

Chari²

The Pancreapedia: Exocrine Pancreas Knowledge Base

View full text Add to dashboard Cite

Autoimmune pancreatitis (AIP) is a distinct form of chronic pancreatitis that is increasingly being reported. The presentation and clinical image findings of AIP sometimes resemble those of several pancreatic malignancies, but the therapeutic strategy differs appreciably. Therefore, accurate diagnosis is necessary for cases of AIP. To date, AIP is classified into two distinct subtypes from the viewpoints of etiology, serum markers, histology, other organ involvements, and frequency of relapse: type 1 is related to IgG4 (lymphoplasmacytic sclerosing pancreatitis) and type 2 is related to a granulocytic epithelial lesion (idiopathic duct-centric chronic pancreatitis). Both types of AIP are characterized by focal or diffuse pancreatic enlargement accompanied with a narrowing of the main pancreatic duct, and both show dramatic responses to corticosteroid. Unlike type 2, type 1 is characteristically associated with increasing levels of serum IgG4 and positive serum autoantibodies, abundant infiltration of IgG4-positive plasmacytes, frequent extrapancreatic lesions, and relapse. These findings have led several countries to propose diagnostic criteria for AIP, which consist of essentially similar diagnostic items; however, several differences exist for each country, mainly due to differences in the definition of AIP and the modalities used to diagnose this disease. An attempt to unite the diagnostic criteria worldwide was made with the publication in 2011 of the international consensus diagnostic criteria for AIP, established at the 2010 Congress of the International Association of Pancreatology (IAP).

show abstract