Tokyo Metropolitan Komagome Hospital, Department of Internal Medicine, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
Expert Opin Pharmacother. 2011 Oct;12(14):2149-59. doi: 10.1517/14656566.2011.595710. Epub 2011 Jun 28.
Autoimmune pancreatitis (AIP) is a newly developed concept for a peculiar type of pancreatitis, and at present is recognized as a pancreatic lesion reflecting IgG4-related systemic disease. It is of utmost importance to differentiate AIP from pancreatic cancer to avoid unnecessary surgery.
The current management strategies for AIP, including its clinical features, diagnostic criteria, clinical subtypes, steroid therapy and prognosis are discussed, based on our 66 AIP cases and papers searched in PubMed from 1992 to March 2011, using the term 'autoimmune pancreatitis'. A new clinicopathological entity, an 'IgG4-related sclerosing disease' is also mentioned.
AIP should be considered in the differential diagnosis in elderly male patients presented with obstructive jaundice and pancreatic mass. Steroids are a standard therapy for AIP, but their regimen including maintenance therapy should be evaluated in prospective trials.
自身免疫性胰腺炎(AIP)是一种新提出的胰腺炎特殊类型的概念,目前被认为是反映 IgG4 相关全身性疾病的胰腺病变。将 AIP 与胰腺癌区分开来至关重要,以避免不必要的手术。
根据我们从 1992 年至 2011 年 3 月在 PubMed 上搜索的 66 例 AIP 病例和文献,使用术语“自身免疫性胰腺炎”,讨论了 AIP 的当前管理策略,包括其临床特征、诊断标准、临床亚型、类固醇治疗和预后。还提到了一种新的临床病理实体,即“IgG4 相关硬化性疾病”。
在老年男性患者出现梗阻性黄疸和胰腺肿块时,应考虑进行 AIP 的鉴别诊断。类固醇是 AIP 的标准治疗方法,但应在前瞻性试验中评估其方案,包括维持治疗。