Department of Internal Medicine, Inje University Ilsan Paik Hospital, Koyang, Korea.
J Gastroenterol Hepatol. 2012 Apr;27(4):700-8. doi: 10.1111/j.1440-1746.2011.06934.x.
Type 2 autoimmune pancreatitis (AIP) has been reported mainly in Western countries and is thought to be very rare in Asia. The aim of this study was to compare the prevalence, clinical profiles, detailed radiological findings, and steroid responsiveness between type 1 and type 2 AIP in Korea.
From 120 patients diagnosed with AIP between January 2003 and August 2010, 52 patients with histologically confirmed type 1 (n = 37) or type 2 (n = 15) AIP were included.
The median age of patients with type 2 AIP was significantly lower than that of patients with type 1 AIP (61 vs 34 years, P < 0.05). At initial presentation, severe abdominal pain and presentation with acute pancreatitis were more frequent in patients with type 2 AIP (P < 0.05). On computed tomography scan, the extent of pancreatic enlargement and the frequency of low-density mass did not differ significantly between the two groups. Detailed pancreatographic findings on endoscopic retrograde cholangiopancreatography/magnetic resonance cholangiopancreatography were not significantly different between the two groups. All patients with steroids therapy improved clinically and radiologically in response (25/25 in type 1 AIP and 14/14 in type 2 AIP). During the follow-up period, none of the patients with type 2 AIP experienced relapse.
Type 2 AIP in all histologically confirmed AIP cases in Korea may not be as rare as originally thought, with an estimated prevalence rate of 28.8% (15/52). The detailed radiological findings of type 1 and type 2 AIP were not significantly different, and both subtypes responded well to steroids.
2 型自身免疫性胰腺炎（AIP）主要在西方国家报道，被认为在亚洲非常罕见。本研究旨在比较韩国 1 型和 2 型 AIP 的患病率、临床特征、详细影像学表现和激素反应性。
从 2003 年 1 月至 2010 年 8 月诊断为 AIP 的 120 例患者中，纳入 52 例经组织学证实的 1 型（n=37）或 2 型（n=15）AIP 患者。
2 型 AIP 患者的中位年龄明显低于 1 型 AIP 患者（61 岁比 34 岁，P<0.05）。在初始表现时，2 型 AIP 患者更常出现严重腹痛和急性胰腺炎表现（P<0.05）。在计算机断层扫描上，两组胰腺肿大程度和低密度肿块的发生率无显著差异。内镜逆行胰胆管造影/磁共振胰胆管造影的详细胰管影像学表现两组间无显著差异。所有接受激素治疗的患者均在临床上和影像学上得到改善（1 型 AIP 中 25/25 例，2 型 AIP 中 14/14 例）。在随访期间，2 型 AIP 患者均未复发。
在韩国所有经组织学证实的 AIP 病例中，2 型 AIP 可能不像最初认为的那样罕见，估计患病率为 28.8%（15/52）。1 型和 2 型 AIP 的详细影像学表现无显著差异，两种亚型对激素反应均良好。
