27 research outputs found
A case with overlapping features of IgG4-related autoimmune pancreatitis, Sjögrenâs syndrome and anti-aminoacyl-tRNA synthetase syndrome
Idiopathic retroperitoneal fibrosis associated with IgG4-positive-plasmacyte infiltrations and idiopathic chronic pancreatitis
Autoimmune pancreatitis: an important diagnostic consideration in obstructive jaundice due to a pancreatic mass lesion
Autoimmune pancreatitis associated with biliary stricture, immune thrombocytopenic purpura and lung fibrosis
The therapeutic strategy for autoimmune pancreatitis is subject to the endoscopic features of the duodenal papilla
Autoimmune pancreatitis (AIP) often presents with a swollen duodenal papilla,
however, the clinical significance of the duodenal papilla in AIP has not been
fully elucidated. Data have shown swollen duodenal papillae shaped like a pear
and/or with a submucosal tumor having IgG4-bearing plasma cells.
Immunohistopathology has potentially verified duodenal papillitis associated
with AIP. FOXP3-positive lymphocytes are also recognized in AIP. AIP has shown
spontaneous remission and relapse irrelevance to corticosteroid therapy. The
results of a multivariate analysis revealed the absence of a swollen duodenal
papilla as the only significant independent factor predictive of spontaneous
remission in AIP cases. In addition, the results of another multivariate
analysis revealed the presence of a swollen duodenal papilla and the presence of
extrapancreatic lesions as the significant independent factors predictive of
relapse in these cases. Results suggest that the lack of a swollen duodenal
papilla is a predictive factor for spontaneous remission, and thus negates the
need to administer corticosteroids in those AIP patients. In contrast, a swollen
duodenal papilla and the presence of extrapancreatic lesions are risk factors
for relapse, and those AIP patients are candidates for maintenance
corticosteroid therapy to reduce relapse. Therefore, the therapeutic strategy
such as the indication for corticosteroid administration is subject to the
endoscopic features of the duodenal papilla