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Orphanet J Rare Dis. 2014 May 21;9:77. doi: 10.1186/1750-1172-9-77.

Autoimmune pancreatitis can develop into chronic pancreatitis.

Author information

1
Center for Health, Safety, and Environmental Management, Shinshu University, 3-1-1 Asahi, Matsumoto 390-8621, Japan. skawapc@shinshu-u.ac.jp.

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.

PMID:
24884922
PMCID:
PMC4038704
DOI:
10.1186/1750-1172-9-77
[Indexed for MEDLINE]
Free PMC Article

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