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Gastrointest Endosc Clin N Am. 2018 Oct;28(4):493-519. doi: 10.1016/j.giec.2018.05.002. Epub 2018 Aug 1.

Management of Autoimmune Pancreatitis.

Author information

1
Department of Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA; Department of Medicine, Waterbury Internal Medicine Residency Program, Waterbury Hospital, Yale New Haven Hospital, Main 3, 64 Robbins Street, Waterbury, CT 06708, USA.
2
Section of Digestive Diseases, Yale University School of Medicine, Yale Center for Pancreatic Disease, Yale University, LMP 1080, 15 York Street, New Haven, CT 06510, USA. Electronic address: james.j.farrell@yale.edu.

Abstract

Type 1 autoimmune pancreatitis (AIP) is an IgG-4-related systemic disease that can manifest as a pancreatic disorder or another disorder of presumed autoimmune origin. Type 2 disease is typically characterized by absent IgG-4-positive cells. As patients often present with acute pancreatitis, obstructive jaundice, or pancreatic mass, it is imperative to exclude malignancy, a more common diagnosis. AIP may respond to corticosteroids, and has a strong association with other immune-mediated diseases. Recent literature suggests the benefit of immune-modulating therapy, including rituximab, although no consensus exists. This review covers the essentials of diagnosis, but focuses primarily on management of AIP.

KEYWORDS:

Autoimmune pancreatitis; Azathioprine; Corticosteroids; Idiopathic duct centric pancreatitis; IgG-4; Immunomodulator; Lymphoplasmacytic sclerosing pancreatitis; Rituximab

PMID:
30241640
DOI:
10.1016/j.giec.2018.05.002
[Indexed for MEDLINE]

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