Clinical significance of extrapancreatic lesions in autoimmune pancreatitis.

Published on Jan 1, 2010in Pancreas2.92
· DOI :10.1097/MPA.0B013E3181BD64A1
Itaru Naitoh19
Estimated H-index: 19
,
Takahiro Nakazawa29
Estimated H-index: 29
+ 9 AuthorsTakashi Joh52
Estimated H-index: 52
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Abstract
Objectives:To clarify the frequency and clinical significance of extrapancreatic lesions in autoimmune pancreatitis (AIP).Methods:The frequency and clinical characteristics of extrapancreatic lesions during the clinical course of AIP were investigated retrospectively in 64 patients with AIP. The pre
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Objective Serum IgG4 levels are frequently elevated in patients with autoimmune pancreatitis (AIP). AIP is sometimes associated with various extra pancreatic lesions. This study examined whether there is a correlation between serum IgG4 levels and associated extra pancreatic lesions in AIP patients. Methods Serum IgG4 levels were measured in 40 AIP patients before therapy. In these patients, four associated extrapancreatic lesions (sclerosing cholangitis, sclerosing cholecystitis, sclerosing sia...
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#1Do Hyun Park (SCH: Soonchunhyang University)H-Index: 47
#2Myung-Hwan Kim (UOU: University of Ulsan)H-Index: 68
Last. Sung Koo Lee (UOU: University of Ulsan)H-Index: 53
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Background & Aims: Although autoimmune pancreatitis (AIP) responds well to corticosteroid therapy, relapse during maintenance corticosteroid therapy or after the withdrawal of corticosteroid treatment is not uncommon. To date, the factors related to relapse of AIP have not been fully explored. Methods: To determine the clinical and genetic predictors relating to the relapse of AIP, we evaluated clinical factors, HLA polymorphisms, and the amino acid sequences in 40 patients with AIP. Results: At...
167 CitationsSource
#1Kensuke Kubota (YCU: Yokohama City University)H-Index: 30
#2Hiroshi Iida (YCU: Yokohama City University)H-Index: 22
Last. A. Nakajima (YCU: Yokohama City University)H-Index: 10
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Background The rates of spontaneous remission and relapse of autoimmune pancreatitis (AIP) are not known. Objective To study the clinicopathologic factors predictive of remission and relapse in cases of AIP. Design Retrospective study. Patients Of the 20 patients with AIP, complete response to steroid therapy was recognized in 12 patients, and the remaining 8 patients improved without steroid therapy. Seven patients experienced a relapse. Results Patients who were seronegative for immunoglobulin...
150 CitationsSource
#1Kenji Hirano (UTokyo: University of Tokyo)H-Index: 39
#2Minoru TadaH-Index: 46
Last. Masao OmataH-Index: 105
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Objectives: Autoimmune pancreatitis (AIP) is a unique form of chronic pancreatitis, and it has a favorable response to corticosteroid treatment (CST). However, little is known about the long-term outcome of AIP. We aimed to document the prognosis without and with CST, and to examine the indication for CST. Patients and Methods: Prognosis and clinical features of 23 patients without CST and 19 patients treated with CST from onset were investigated. In addition, we examined factors concerning the ...
309 CitationsSource
#1Hideaki Hamano (Shinshu University)H-Index: 38
#2Norikazu Arakura (Shinshu University)H-Index: 21
Last. Shigeyuki Kawa (Shinshu University)H-Index: 55
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Background Autoimmune pancreatitis is a unique form of chronic pancreatitis characterized by high serum IgG4 concentrations and abundant IgG4-bearing plasma cell infiltration in the pancreatic lesion, and it has been reported to be associated with a variety of extrapancreatic lesions, leading us to postulate the concept of a systemic inflammatory disease. To confirm this, we clarified the exact distribution of these extrapancreatic lesions and provide a panoramic view of them.
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#1Lizhi Zhang (Mayo Clinic)H-Index: 7
#1Lizhi Zhang (Mayo Clinic)H-Index: 44
Last. Thomas C. Smyrk (Mayo Clinic)H-Index: 98
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Autoimmune pancreatitis typically produces an enlarged pancreas with narrowing of the pancreatic duct, and can mimic carcinoma. Autoimmune pancreatitis usually responds to corticosteroid treatment, making it important to differentiate from pancreatic ductal adenocarcinoma. Affected patients often have an elevated serum IgG4. It has been proposed that increased numbers of IgG4-positive plasma cells in tissue might be a marker for the condition. We investigated the role of IgG4 staining in the dia...
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Background & Aims: The Japan Pancreas Society criteria for diagnosis of autoimmune pancreatitis (AIP) mandate presence of characteristic imaging (diffuse pancreatic enlargement with diffusely irregular, narrow pancreatic duct). AIP has unique histologic features associated with infiltration of tissues of affected organs with abundant IgG4-positive cells. We propose expanded diagnostic criteria for AIP with a cohort of histologically confirmed AIP. Methods: We reviewed the pancreatic imaging find...
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In 1961, Sarles et al.1 asked the following question regarding the particular cases of pancreatitis with hypergammaglobulinemia: “Chronic inflammatory sclerosis of the pancreas—an autoimmune pancreatic disease?” As similar cases were rarely observed, a relationship between such pancreatitis and autoimmunity was viewed skeptically during the following several decades. In 1992, Toki et al.2 have reported 4 cases with unusual diffuse irregular narrowing of the main pancreatic duct and diffuse enlar...
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Abstract Background Recently, it has been reported that the serum concentration of IgG4, a minor component of IgG subclasses, is increased in autoimmune pancreatitis. However, data regarding IgG4 concentrations in other pancreatic or biliary diseases have been insufficient. Methods Serum IgG4 was measured in 116 patients with pancreatic or biliary diseases (35 autoimmune pancreatitis, 24 chronic pancreatitis except autoimmune pancreatitis, 11 primary sclerosing cholangitis, 23 pancreatic cancer,...
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#2Myung-Hwan KimH-Index: 68
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Autoimmune chronic pancreatitis (AIP) is increasingly being recognized worldwidely, as knowledge of this entity builds up. Above all, AIP is a very attractive disease to clinicians in terms of its dramatic response to the oral steroid therapy in contrast to ordinary chronic pancreatitis. Although many characteristic findings of AIP have been described, definite diagnostic criteria have not been fully established. In the year 2002, the Japan Pancreas Society published the diagnostic criteria of A...
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Resumen La enfermedad relacionada con IgG4 (ER-IgG4) es una enfermedad sistemica reconocida. Se describio tras observarse que pacientes diagnosticados de pancreatitis autoinmune mostraban signos de enfermedad extrapancreatica. La clinica de estos pacientes es subaguda y se manifiesta por aparicion de lesiones seudotumorales, o tumores inflamatorios o fibrosos. En ocasiones, puede ser grave, como en el caso de pacientes con colangitis o vasculitis de gran vaso. Los criterios diagnosticos incluyen...
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Autoimmune pancreatitis (AIP) is an inflammatory process of the pancreas that occurs most commonly in elderly males and clinically can mimic pancreatic adenocarcinoma and present with jaundice, weight loss, and abdominal pain. Mass-forming lesions in the pancreas are seen in the focal form of AIP and both clinical and imaging findings can overlap those of pancreatic cancer. The accurate distinction of AIP from pancreatic cancer is of utmost importance as it means avoiding unnecessary surgery in ...
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AbstractObjectives: Steroids are the first-line drugs for induction of remission in patients with type 1 autoimmune pancreatitis (AIP), and the usefulness of steroid maintenance therapy to prevent ...
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Introduction: Autoimmune pancreatitis (AIP) type 1 is a special form of chronic pancreatitis with a strong lymphocytic infiltration as the pathological hallmark and other organ involvement (OOI). IgG4-related kidney disease (IgG4-RKD) was first reported as an extrapancreatic manifestation of AIP in 2004. The aim of the present study was to determine the frequency and clinical impact of kidney lesions observed in patients with AIP type 1. Methods: We performed a single-centre retrospective study ...
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IgG4-related disease (IgG4-RD) is characterized by increased serum IgG4 and swelling of several organs or nodules by infiltration of IgG4-positive plasma cells and lymphocytes, as well as fibrosis observed throughout the body. In the gastrointestinal area, autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-SC) are primarily observed. In 2010, the International Consensus Diagnostic Criteria (ICDC) for AIP were proposed, and in 2012, clinical diagnostic criteria for IgG4-S...
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Hintergrund Mesenteriale und peritoneale inflammatorische Prozesse stellen eine grose klinische Herausforderung bezuglich der Differenzialdiagnosen dar. In diesem Ubersichtsartikel wird ein systematischer Uberblick uber die haufigsten Ursachen, eingeteilt nach Autoimmunreaktionen, Infarzierung mit Nekrosen und Protozoen bzw. bakteriellen Infektionen, gegeben.
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