Autoimmune pancreatitis

Intern Med. 2005 Dec;44(12):1215-23. doi: 10.2169/internalmedicine.44.1215.

Abstract

Although the pathogenesis of autoimmune pancreatitis is unclear, recent evidence of clinical aspects are presented: (i) mild abdominal symptoms, usually without acute attacks of pancreatitis; (ii) occasional existence of obstructive jaundice; (iii) increased levels of serum gammaglobulin, IgG or IgG4; (iv) presence of autoantibodies; (v) diffuse enlargement of the pancreas; (vi) irregularly narrowing of the pancreatic duct (sclerosing pancreatitis) with often intra-pancreatic biliary stenosis or coexistence of biliary lesions (sclerosing cholangitis similar to primary sclerosing cholangitis: PSC) on endoscopic retrograde cholangiopancreatographic (ERCP) images; (vii) fibrotic changes with lymphocyte and IgG4-positive plasmacyte infiltration, and obliterative thrombo-phlebitis; (viii) occasional association with other systemic lesions such as sialoadenitis, retroperitoneal fibrosis, interstitial renal tubular disorders, and (ix) effective steroid therapy. In addition to pancreatic and extra-pancreatic lesions, diabetes mellitus is occasionally responsive to steroid therapy. Further studies are needed to clarify the pathogenesis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Autoantibodies / blood
  • Autoimmune Diseases*
  • Biomarkers / blood
  • Diagnosis, Differential
  • Humans
  • Immunoglobulin G / blood
  • Pancreatitis / blood
  • Pancreatitis / diagnosis
  • Pancreatitis / immunology*
  • gamma-Globulins / metabolism

Substances

  • Autoantibodies
  • Biomarkers
  • Immunoglobulin G
  • gamma-Globulins