Rana Surinder S, Gupta Rajesh, Nada Ritambhra, Gupta Pankaj, Basher Rajinder, Mittal Bhagwat R, Sharma Ravi Kumar, Rawat Amit
Department of Gastroenterology (Surinder S. Rana, Pankaj Gupta, Ravi kumar Sharma), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh India.
Department of Surgery (Rajesh Gupta), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh India.
Ann Gastroenterol. 2018 Jul-Aug;31(4):506-512. doi: 10.20524/aog.2018.0267. Epub 2018 Apr 28.
Autoimmune pancreatitis (AIP) is a rare disease, and data from countries like India concerning its clinical presentation and long-term outcomes are scarce. We retrospectively evaluated the clinical presentation, imaging features and treatment outcomes of patients with AIP.
We carried out a retrospective analysis of our database to identify patients diagnosed with and treated for AIP at our unit in a tertiary care hospital in North India.
Eighteen patients with AIP (mean age: 54.9±11.1 years; 13 male) were evaluated. Of these, 9 (50%) patients had probable type 1 AIP, 2 (11%) patients probable type 2 AIP, and 4 (22%) definite type 1 AIP. Patients with type 2 AIP were significantly younger than patients with type 1 (40.0±2.8 vs. 58.4±9.6 years). In type 1 AIP, other organ involvement was observed in 3/18 (17%) patients, whereas both patients with type 2 AIP had coexisting ulcerative colitis. The diagnosis of AIP was made after resective surgery in 6/18 (33.0%) patients. An accurate diagnosis of AIP could be made in all patients who underwent resection or core biopsy, but cytological examination after endoscopic ultrasound-guided fine-needle aspiration could not provide a definitive diagnosis in any patient. Initial treatment with steroids was given to 12 (67%) patients, with a 100% response, but the disease relapsed in 5/13 (38%) patients over a mean follow-up period of 34.2±21.6 weeks.
AIP is not rare in India and the majority of clinical manifestations, imaging features, treatment response and long-term outcomes are similar to those reported in the literature.
自身免疫性胰腺炎(AIP)是一种罕见疾病,来自印度等国家的关于其临床表现和长期预后的数据稀缺。我们回顾性评估了AIP患者的临床表现、影像学特征及治疗结果。
我们对数据库进行回顾性分析,以识别在印度北部一家三级护理医院我们科室被诊断并接受治疗的AIP患者。
对18例AIP患者(平均年龄:54.9±11.1岁;13例男性)进行了评估。其中,9例(50%)患者可能为1型AIP,2例(11%)患者可能为2型AIP,4例(22%)为确诊的1型AIP。2型AIP患者明显比1型患者年轻(40.0±2.8岁对58.4±9.6岁)。在1型AIP中,3/18(17%)患者有其他器官受累,而2例2型AIP患者均合并溃疡性结肠炎。6/18(33.0%)患者在接受切除手术后确诊为AIP。所有接受切除或芯针活检的患者均可准确诊断为AIP,但内镜超声引导下细针穿刺后的细胞学检查未能在任何患者中提供明确诊断。12例(67%)患者最初接受了类固醇治疗,缓解率为100%,但在平均34.2±21.6周的随访期内,5/13(38%)患者疾病复发。
AIP在印度并不罕见,其大多数临床表现、影像学特征、治疗反应及长期预后与文献报道相似。