| Theme |
Autoimmune Diseases in Gastroenterology |
| Title |
Autoimmune Pancreatitis : Characteristics of Clinical Features |
| Author |
Ryoichi Narita |
Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine |
| Author |
Makoto Otsuki |
Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine |
| [ Summary ] |
Autoimmune pancreatitis is a rare form of pancreatitis, in which autoimmunity is a suspected pathogenic mechanism. Autoimmune pancreatitis is more common in elderly men and the clinical findings include obstructive jaundice secondary to biliary stenosis, mild epigastralgia, and diabetes mellitus. Imaging studies on patients with autoimmune pancreatitis demonstrate diffuse enlargement of the pancreas and diffuse narrowing of the main pancreatic duct with irregular walls. The caliber of the pancreatic duct is smaller than in the normal control group and irregular narrowing is observed in more than one third of the length of the entire pancreas. Furthermore, high levels of serum Gamma-globulin or IgG and the presence of autoantibodies are frequently associated with autoimmune pancreatitis. Steroid therapy is often beneficial. The prognosis for autoimmune pancreatitis is generally good. Although prompt response to oral steroid therapy may be helpful in the differential diagnosis of autoimmune pancreatitis, careful imaging studies are necessary to exclude cancer of the pancreas or the common bile duct. |