Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Pancreas. 2010 Jul;39(5):555-60. doi: 10.1097/MPA.0b013e3181c8b4a5.
Autoimmune pancreatitis (AIP) is a type of chronic pancreatitis characterized by swelling of the pancreas, narrowing of the main pancreatic duct, elevation of serum immunoglobulin G or G4 level or presence of several autoantibodies, or lymphoplasmacytic infiltration and fibrosis in the pancreas. However, the pathogenesis of AIP remains unclear, and the natural history and long-term prognosis of AIP are little known. Oral corticosteroid therapy for AIP is recommended. The absolute indications for steroid therapy for AIP are bile duct stenosis and accompanying systemic disease such as retroperitoneal fibrosis and diabetes mellitus. The dosage for remission induction is 30 to 40 mg/d for 1 to 2 months. The remission maintenance is needed to prevent relapse, and 5 to 10 mg/d for at least 6 months is recommended in patients who do not have complete remission. When relapse occurs, the dose used at remission induction can be readministered. Herein, we discuss remission and relapse of AIP, focusing on corticosteroid treatment to help clinicians care for patients with AIP and to help make an ideal treatment protocol of AIP through a review of published data. We tried to define remission and relapse of AIP to help investigate the natural course of AIP.
自身免疫性胰腺炎（AIP）是一种慢性胰腺炎，其特征为胰腺肿胀、主胰管狭窄、血清免疫球蛋白 G 或 G4 水平升高或存在多种自身抗体，或胰腺内淋巴浆细胞浸润和纤维化。然而，AIP 的发病机制仍不清楚，AIP 的自然病史和长期预后也知之甚少。推荐使用口服皮质类固醇治疗 AIP。AIP 皮质类固醇治疗的绝对适应证是胆管狭窄和腹膜后纤维化和糖尿病等伴随的全身性疾病。缓解诱导的剂量为 1 至 2 个月，每天 30 至 40 毫克。为了预防复发，需要缓解维持，建议在未完全缓解的患者中每天使用 5 至 10 毫克至少 6 个月。当复发时，可以重新给予缓解诱导时使用的剂量。在此，我们讨论 AIP 的缓解和复发，重点讨论皮质类固醇治疗，以帮助临床医生照顾 AIP 患者，并通过回顾已发表的数据来帮助制定 AIP 的理想治疗方案。我们试图定义 AIP 的缓解和复发，以帮助研究 AIP 的自然病程。
