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- Title
Autoimmune pancreatitis can develop into chronic pancreatitis.
- Authors
Masahiro Maruyama; Takayuki Watanabe; Keita Kanai; Takaya Oguchi; Jumpei Asano; Tetsuya Ito; Yayoi Ozaki; Takashi Muraki; Hideaki Hamano; Norikazu Arakura; Shigeyuki Kawa
- Abstract
Autoimmune pancreatitis (AIP) has been recognized as a distinct type of pancreatitis that is possibly caused by autoimmune mechanisms. AIP is characterized by high serum IgG4 and IgG4-positive plasma cell infiltration in affected pancreatic tissue. Acute phase AIP responds favorably to corticosteroid therapy and results in the amelioration of clinical findings. However, the long-term prognosis and outcome of AIP remain unclear. We have proposed a working hypothesis that AIP can develop into ordinary chronic pancreatitis resembling alcoholic pancreatitis over a long-term course based on several clinical findings, most notably frequent pancreatic stone formation. In this review article, we describe a series of study results to confirm our hypothesis and clarify that: 1) pancreatic calcification in AIP is closely associated with disease recurrence; 2) advanced stage AIP might have earlier been included in ordinary chronic pancreatitis; 3) approximately 40% of AIP patients experience pancreatic stone formation over a long-term course, for which a primary risk factor is narrowing of both Wirsung's and Santorini's ducts; and 4) nearly 20% of AIP patients progress to confirmed chronic pancreatitis according to the revised Japanese Clinical Diagnostic Criteria, with independent risk factors being pancreatic head swelling and non-narrowing of the pancreatic body duct.
- Subjects
PANCREATITIS; PANCREATIC diseases; AUTOIMMUNE diseases; CHRONIC diseases; PROGNOSIS; DISEASE relapse
- Publication
Orphanet Journal of Rare Diseases, 2014, Vol 9, Issue 1, p1
- ISSN
1750-1172
- Publication type
Article
- DOI
10.1186/1750-1172-9-77