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韩国67例自身免疫性胰腺炎患者的回顾:一项全国多中心研究。

Review of 67 patients with autoimmune pancreatitis in Korea: a multicenter nationwide study.

作者信息

Ryu Ji Kon, Chung Jae Bock, Park Seung Woo, Lee Jong Kyun, Lee Kyu Tack, Lee Woo Jin, Moon Jong Ho, Cho Kwang Bum, Kang Dae Whan, Hwang Jin-Hyeok, Yoo Kyo-Sang, Yoo Byung Moo, Lee Don Hang, Kim Hae Kyung, Moon Young Soo, Lee Jin, Lee Hong Sik, Choi Ho Sun, Lee Sung Koo, Kim Yong-Tae, Kim Chang Duck, Kim Sun Joo, Hahm Joon Soo, Yoon Yong Bum

机构信息

Autoimmune Pancreatitis Study Group, Korean Society of Pancreatobiliary Diseases, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Pancreas. 2008 Nov;37(4):377-85. doi: 10.1097/MPA.0b013e31817a0914.

Abstract

OBJECTIVES

The ideal diagnostic criteria of autoimmune pancreatitis (AIP) are still challenging. Therefore, we investigated the clinical features of AIP in Korea and assessed the clinical use of new Korean diagnostic criteria.

METHODS

We reviewed 67 patients with AIP enrolled in 16 hospitals via a multicenter study. The diagnosis was confirmed according to the Korean diagnostic criteria that included pancreatic imaging, laboratory findings, histopathology, and response to steroid.

RESULTS

Mean age of the patients was 56 years, and 73% were men. Obstructive jaundice (52%) was the most common symptom, and 14 patients (21%) had other organ involvement. Fifty-four patients (81%) revealed diffuse swelling of the pancreas. Either immunoglobulin (Ig)G or IgG4 was elevated in 76%. According to the Korean criteria, 65 patients had definite diagnostic criteria, and 2 patients had probable criteria. Fifteen patients were fulfilled with image, serological, and histopathologic criteria, and 4 patients could be diagnosed with image and steroid responsiveness. Ten patients experienced recurrent attacks of AIP during the mean 20-month follow-up.

CONCLUSIONS

Among 67 cases of AIP, either IgG or IgG4 was elevated in 76% of patients, and 14 patients (21%) had other organ involvement. New Korean diagnostic criteria are useful for diagnosis of AIP.

摘要

目的

自身免疫性胰腺炎(AIP)的理想诊断标准仍具有挑战性。因此,我们调查了韩国AIP的临床特征,并评估了韩国新诊断标准的临床应用情况。

方法

我们通过一项多中心研究,回顾了16家医院收治的67例AIP患者。诊断依据韩国诊断标准确定,该标准包括胰腺影像学检查、实验室检查结果、组织病理学检查以及对类固醇的反应。

结果

患者的平均年龄为56岁,73%为男性。梗阻性黄疸(52%)是最常见的症状,14例患者(21%)有其他器官受累。54例患者(81%)显示胰腺弥漫性肿大。76%的患者免疫球蛋白(Ig)G或IgG4升高。根据韩国标准,65例患者有明确的诊断标准,2例患者有可能的标准。15例患者符合影像学、血清学和组织病理学标准,4例患者可根据影像学和类固醇反应性进行诊断。在平均20个月的随访期间,10例患者经历了AIP的复发。

结论

在67例AIP病例中,76%的患者IgG或IgG4升高,14例患者(21%)有其他器官受累。韩国新诊断标准对AIP的诊断有用。

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