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自身免疫性胰腺炎的诊断与管理

Diagnosis and Management of Autoimmune Pancreatitis.

作者信息

Hart Phil A, Krishna Somashekar G, Okazaki Kazuichi

机构信息

Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, 410 West Tenth Avenue, Columbus, OH, 43210, USA.

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

出版信息

Curr Treat Options Gastroenterol. 2017 Dec;15(4):538-547. doi: 10.1007/s11938-017-0147-x.

Abstract

Although autoimmune pancreatitis is a relatively uncommon pancreatic disorder, it is an important consideration in the differential diagnosis of jaundice and pancreatic masses to avoid unnecessary surgical resection. The clinical diagnosis of autoimmune pancreatitis involves considering multiple pieces of information including the pancreatic imaging, serum IgG4 level, presence of characteristic other involvement, and histologic findings. Unlike other pancreatic disorders, this condition rapidly responds to treatment with steroids. In the more common disease subtype (type 1 autoimmune pancreatitis) disease relapses can occur necessitating the use of maintenance treatment with low-dose steroids, steroid-sparing immunomodulators, or rituximab. This chapter reviews the diagnosis and treatment of the autoimmune pancreatitis subtypes.

摘要

尽管自身免疫性胰腺炎是一种相对罕见的胰腺疾病,但在黄疸和胰腺肿块的鉴别诊断中,它是一个重要的考虑因素,以避免不必要的手术切除。自身免疫性胰腺炎的临床诊断需要综合考虑多方面信息,包括胰腺影像学检查、血清IgG4水平、是否存在特征性的其他受累情况以及组织学检查结果。与其他胰腺疾病不同,这种疾病对类固醇治疗反应迅速。在更常见的疾病亚型(1型自身免疫性胰腺炎)中,疾病可能会复发,需要使用低剂量类固醇、类固醇替代免疫调节剂或利妥昔单抗进行维持治疗。本章将综述自身免疫性胰腺炎各亚型的诊断和治疗。

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