A middle-aged man presents with acute pancreatitis of unknown etiology and is found to have a presentation consistent with the diagnosis of type 2 autoimmune pancreatitis (AIP). AIP is a group of rare heterogeneous diseases that are challenging to diagnose. There are 2 types of AIP. Type 1 disease is the more common worldwide than type 2 AIP. While type 1 AIP is associated with IgG4-positive antibodies, type 2 AIP is IgG4 antibody negative. Both types of AIP are responsive to corticosteroid treatment. Although type 1 AIP has more extrapancreatic manifestations and more commonly relapses, this is a case of a patient with type 2 AIP with inflammatory bowel disease and relapsing course.
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http://dx.doi.org/10.1177/2324709617734245 | DOI Listing |
Endosc Ultrasound
December 2024
Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital; and National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai, China.
Background And Objectives: EUS is recommended for guiding pancreatic tissue acquisition in suspected autoimmune pancreatitis (AIP) cases. However, there is a lack of comparative research on the effectiveness between EUS-guided fine-needle aspiration (EUS-FNA) and EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing AIP in China. This study aimed to evaluate the diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) specifically for type 1 AIP.
View Article and Find Full Text PDFInt J Surg Pathol
January 2025
Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
IgG4-related disease (IgG4-RD) is an autoimmune disease of unknown cause. is a transcription factor involved in immune responses, and its dysfunction leads to uncontrolled immune responses. We performed, to our knowledge, the first methylation analysis in type 1 autoimmune pancreatitis (denoted simply as AIP), a representative IgG4-RD.
View Article and Find Full Text PDFBackground: Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis that presents clinically with obstructive icterus, histologically with infiltration of pancreatic parenchyma by inflammatory cells leading to chronic inflammation with fibrosis, and therapeutically with good response to corticosteroid therapy. Clinically, it may resemble malignant disease, making diagnosis difficult and requiring a multidisciplinary team (gastroenterologist, endoscopist, radiologist, surgeon, pathologist). Two types of AIP are distinguished.
View Article and Find Full Text PDFAbdom Radiol (NY)
January 2025
First Affiliated Hospital Zhejiang University, Hangzhou, China.
Purpose: This study aimed to investigate the usefulness of ultrasound-guided core-needle biopsy (US-CNB) for diagnosing type 1 AIP and evaluate the radiological outcomes following steroid therapy.
Materials And Methods: From January 2017 to June 2023, patients with pathology results containing "lymphoplasmacytic infiltration" and "fibrosis" were enrolled. The detection rate of level 1 histology by International Consensus Diagnostic Criteria (ICDC) and the contribution of US-CNB were assessed.
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