Challenges for clinicians treating autoimmune pancreatitis: Current perspectives

Abstract

Autoimmune pancreatitis (AIP) is a rare disease clinically characterized by obstructive jaundice, unintentional weight loss, acute pancreatitis, focal pancreatic mass, and diabetes. AIP is classified into two subtypes - type 1 and type 2 - according to pathological findings, clinical features, and serology test results, but some cases may be defined as type not otherwise in the absence of pathological findings and inflammatory bowel disease. To address the differences in diagnostic criteria by country, standard diagnostic criteria for AIP were proposed in 2011 by an international consensus of expert opinions. Differential diagnosis of AIP from pancreatic ductal adenocarcinoma is important but remains challenging for clinicians. Fortunately, all subtypes of AIP show dramatic response to steroid treatment. This review discusses the current perspectives on the diagnosis and management of AIP in clinical practice.

A Case of Autoimmune Pancreatitis Presenting As Alcohol-Induced Necrotizing Pancreatitis

“…In 2001, Hamano et al [ 16 ] described the use of IgG4 in diagnosing AIP and differentiating it from malignancy and other causes of pancreatitis [ 13 , 16 , 17 ]. Specifically, serum IgG4 levels greater than 140 mg/dL have been reported to have a sensitivity of 86% and a specificity of up to 96% for diagnosing AIP, and our patient's labs revealed an IgG4 level of 302 mg/dL [ 18 , 19 ].…”