Kim Seong-Hun, Lee Yun Chae, Chon Hyung Ku
Division of Gastroenterology, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54907, South Korea.
Department of Internal Medicine, Institution of Wonkwang Medical Science, Wonkwang University School of Medicine and Hospital, Iksan 54538, South Korea.
World J Clin Cases. 2023 Jan 6;11(1):30-46. doi: 10.12998/wjcc.v11.i1.30.
Autoimmune pancreatitis (AIP) is a rare disease clinically characterized by obstructive jaundice, unintentional weight loss, acute pancreatitis, focal pancreatic mass, and diabetes. AIP is classified into two subtypes - type 1 and type 2 - according to pathological findings, clinical features, and serology test results, but some cases may be defined as type not otherwise in the absence of pathological findings and inflammatory bowel disease. To address the differences in diagnostic criteria by country, standard diagnostic criteria for AIP were proposed in 2011 by an international consensus of expert opinions. Differential diagnosis of AIP from pancreatic ductal adenocarcinoma is important but remains challenging for clinicians. Fortunately, all subtypes of AIP show dramatic response to steroid treatment. This review discusses the current perspectives on the diagnosis and management of AIP in clinical practice.
自身免疫性胰腺炎(AIP)是一种罕见疾病,临床特征为梗阻性黄疸、非故意体重减轻、急性胰腺炎、胰腺局灶性肿块和糖尿病。根据病理结果、临床特征和血清学检测结果,AIP可分为1型和2型两个亚型,但在缺乏病理结果且无炎症性肠病的情况下,有些病例可能被定义为其他类型。为解决各国诊断标准的差异问题,2011年通过专家意见的国际共识提出了AIP的标准诊断标准。AIP与胰腺导管腺癌的鉴别诊断很重要,但对临床医生来说仍然具有挑战性。幸运的是,AIP的所有亚型对类固醇治疗均表现出显著反应。本综述讨论了临床实践中AIP诊断和管理的当前观点。