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自身免疫性胰腺炎治疗的国际共识

International consensus for the treatment of autoimmune pancreatitis.

作者信息

Okazaki Kazuichi, Chari Suresh T, Frulloni Luca, Lerch Markus M, Kamisawa Terumi, Kawa Shigeyuki, Kim Myung-Hwan, Lévy Philippe, Masamune Atsushi, Webster George, Shimosegawa Tooru

机构信息

Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Japan.

Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

出版信息

Pancreatology. 2017 Jan-Feb;17(1):1-6. doi: 10.1016/j.pan.2016.12.003. Epub 2016 Dec 12.

Abstract

BACKGROUND AND AIMS

The International Consensus Diagnostic Criteria (ICDC) for AIP has proposed two distinctive type of AIP, type 1 and type 2, and enabled us first to differentiate two types of AIP each other. By initial steroid treatment for induction of remission, remission can be successfully induced in almost all subjects with type 1 and type 2 AIP. As relapse rate in type 1 AIP is significantly higher than in type 2 AIP, there has been ongoing debate on how to treat effectively relapse of type 1 AIP.

METHODS

By a modified Delphi approach, a panel of international experts has proposed an international consensus on the treatment of AIP after intense discussion and deliberation during an international consensus symposium of the International Association of Pancreatology (IAP) 2016.

RESULTS

Individual statements for nine clinical questions with recommendation levels and the therapeutic strategy have been proposed.

CONCLUSION

The recommendations are based on the available evidence, and eastern and western experts' opinions to find standard treatment of AIP worldwide. These recommendations can be tailored according to the local expertise and context in the management of individual patients.

摘要

背景与目的

自身免疫性胰腺炎(AIP)的国际共识诊断标准(ICDC)提出了两种不同类型的AIP,即1型和2型,使我们首次能够区分这两种类型的AIP。通过初始类固醇治疗诱导缓解,几乎所有1型和2型AIP患者都能成功诱导缓解。由于1型AIP的复发率明显高于2型AIP,因此关于如何有效治疗1型AIP复发的争论一直在持续。

方法

通过改良的德尔菲法,一个国际专家小组在2016年国际胰腺病协会(IAP)国际共识研讨会上经过激烈讨论和审议,就AIP的治疗提出了国际共识。

结果

针对九个临床问题提出了具有推荐等级的个人声明和治疗策略。

结论

这些建议基于现有证据以及东西方专家的意见,旨在寻找全球范围内AIP的标准治疗方法。这些建议可根据当地专业知识和个体患者管理的具体情况进行调整。

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