Skip to main content

Advertisement

SpringerLink
Log in

Autoimmune pancreatitis

  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

The list of diseases associated with autoantibodies against tissues, cells, or specific autoantigens is growing, and many organs in the body are known to be affected by autoimmune injury. Until recently, the most well-known pancreatic autoimmune disorder was type 1 diabetes mellitus, where there is selective destruction of beta cells in the islets of Langerhans. Although an autoimmune process affecting the exocrine pancreas was suspected over four decades ago, it is only in the past 10 years or so that autoimmune chronic pancreatitis has been recognized as a distinct entity. Here we review the clinical, serologic, radiologic, and histologic features of autoimmune pancreatitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Yoshida K, Toki F, Takeuchi T, et al.: Chronic pancreatitis caused by an autoimmune abnormality: proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 1995, 40:1561–1568.

    Article  PubMed  CAS  Google Scholar 

  2. Okazaki K, Chiba T: Autoimmune related pancreatitis. Gut 2002, 51:1–4.

    Article  PubMed  CAS  Google Scholar 

  3. Kloppel G, Luttges J, Lohr M, et al.: Autoimmune pancreatitis: pathological, clinical, and immunological features. Pancreas 2003, 27:14–19.

    Article  PubMed  Google Scholar 

  4. Yadav D, Notahara K, Smyrk TC, et al.: Idiopathic tumefactive chronic pancreatitis: clinical profile, histology, and natural history after resection. Clin Gastroenterol Hepatol 2003, 1:129–135. Comparison of clinical and histologic features of alcoholic chronic pancreatitis, lymphoplasmacytic sclerosing pancreatitis, and its variant of duct-centric pancreatitis.

    Article  PubMed  Google Scholar 

  5. Pearson RK, Longnecker DS, Chari ST, et al.: Controversies in clinical pancreatology: autoimmune pancreatitis: does it exist? Pancreas 2003, 27:1–13. Review of recent worldwide experience with autoimmune pancreatitis.

    Article  PubMed  Google Scholar 

  6. Sarles H, Sarles JC, Muratore R, Guien C: Chronic inflammatory sclerosis of the pancreas: an autonomous pancreatic disease? Am J Dig Dis 1961, 6:688–698.

    Article  PubMed  CAS  Google Scholar 

  7. Sood S, Fossard DP, Shorrock K: Chronic sclerosing pancreatitis in Sjogren’s syndrome: a case report. Pancreas 1995, 10:419–421.

    Article  PubMed  CAS  Google Scholar 

  8. Weber SM, Cubukcu-Dimopulo O, Palesty JA, et al.: Lymphoplasmacytic sclerosing pancreatitis: inflammatory mimic of pancreatic carcinoma. J Gastrointest Surg 2003, 7:129–137.

    Article  PubMed  Google Scholar 

  9. Ectors N, Maillet B, Aerts R, et al.: Non-alcoholic duct destructive chronic pancreatitis. Gut 1997, 41:263–268.

    Article  PubMed  CAS  Google Scholar 

  10. Notohara K, Burgart LJ, Yadav D, et al.: Idiopathic chronic pancreatitis with periductal lymphoplasmacytic infiltration: clinicopathologic features of 35 cases. Am J Surg Path 2003, 27:1119–1127. Detailed description of histology of lymphoplasmacytic sclerosing pancreatitis and its variant of duct-centric pancreatitis.

    Article  PubMed  Google Scholar 

  11. Etemad B, Whitcomb D: Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology 2001, 120:682–707.

    Article  PubMed  CAS  Google Scholar 

  12. Kamisawa T, Funata N, Hayashi Y, et al.: A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol 2003, 38:982–984. Study shows IgG4-laden plasma cells in multiple organs suggesting that AIP may be a systemic disease.

    Article  PubMed  CAS  Google Scholar 

  13. Kamisawa T, Egawa N, Nakajima H: Autoimmune pancreatitis is a systemic autoimmune disease. Am J Gastroenterol 2003, 98:2811–2812.

    Article  PubMed  Google Scholar 

  14. Kamisawa T, Funata N, Hayashi Y: Lymphoplasmacytic sclerosing pancreatitis is a pancreatic lesion of IgG4-related systemic disease. Am J Surg Path 2004, 28:1114.

    PubMed  Google Scholar 

  15. Chutaputti A, Burrell MI, Boyer JL: Pseudotumor of the pancreas associated with retroperitoneal fibrosis: a dramatic response to corticosteroid therapy. Am J Gastroenterol 1995, 90:1155–1158.

    PubMed  CAS  Google Scholar 

  16. Abraham SC, Wilentz RE, Yeo CJ, et al.: Pancreaticoduodenectomy (Whipple resections) in patients without malignancy: are they all ’chronic pancreatitis’?. Am J Surg Pathol 2003, 27:110–120.

    Article  PubMed  Google Scholar 

  17. Kawaguchi K, Koike M, Tsuruta K, et al.: Lymphoplasmacytic sclerosing pancreatitis with cholangitis: a variant of primary sclerosing cholangitis extensively involving pancreas. Hum Pathol 1991, 22:387–395.

    Article  PubMed  CAS  Google Scholar 

  18. Uchida K, Okazaki K, Konishi Y, et al.: Clinical analysis of autoimmune-related pancreatitis. Am J Gastroenterol 2000, 95:2788–2794.

    Article  PubMed  CAS  Google Scholar 

  19. Hamano H, Kawa S, Horiuchi A, et al.: High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 2001, 344:732–738. First report of elevated serum IgG4 in autoimmune pancreatitis.

    Article  PubMed  CAS  Google Scholar 

  20. Okazaki K, Uchida K, Ohana M, et al.: Autoimmune-related pancreatitis is associated with autoantibodies and a Th1/Th2-type cellular immune response. Gastroenterology 2000, 118:573–581.

    Article  PubMed  CAS  Google Scholar 

  21. Kawa S, Ota M, Yoshizawa K, et al.: HLA DRB10405-DQB10401 haplotype is associated with autoimmune pancreatitis in the Japanese population. Gastroenterology 2002, 122:1264–1269.

    Article  PubMed  Google Scholar 

  22. Wakabayashi T, Kawaura Y, Satomura Y, et al.: Clinical and imaging features of autoimmune pancreatitis with focal pancreatic swelling or mass formation: comparison with socalled tumor-forming pancreatitis and pancreatic carcinoma. Am J Gastroenterol 2003, 98:2679–2687.

    Article  PubMed  Google Scholar 

  23. Ito T, Nakano I, Koyanagi S, et al.: Autoimmune pancreatitis as a new clinical entity: three cases of autoimmune pancreatitis with effective steroid therapy. Dig Dis Sci 1997, 42:1458–1468.

    Article  PubMed  CAS  Google Scholar 

  24. Hong SP, Park SW, Chung JP, et al.: Autoimmune pancreatitis with effective steroid therapy. Yonsei Med J 2003, 44:534–538.

    PubMed  Google Scholar 

  25. Procacci C, Carbognin G, Biasiutti C, et al.: Autoimmune pancreatitis: possibilities of CT characterization. Pancreatology 2001, 1:246–253.

    Article  PubMed  CAS  Google Scholar 

  26. Taniguchi T, Seko S, Azuma K, et al.: Autoimmune pancreatitis detected as a mass in the head of the pancreas with contiguous fibrosis around the superior mesenteric artery. Dig Dis Sci 2001, 46:187–191.

    Article  PubMed  CAS  Google Scholar 

  27. Nakazawa T, Ohara H, Yamada T, et al.: Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis. Hepatogastroenterology 2001, 48:625–630.

    PubMed  CAS  Google Scholar 

  28. Montefusco PP, Geiss AC, Bronzo RL, et al.: Sclerosing cholangitis, chronic pancreatitis, and Sjogren’s syndrome: a syndrome complex. Am J Surg 1984, 147:822–826.

    Article  PubMed  CAS  Google Scholar 

  29. Hirano K, Shiratori Y, Komatsu Y, et al.: Involvement of the biliary system in autoimmune pancreatitis: a follow-up study. Clin Gastroenterol Hepatol 2003, 1:453–464.

    Article  PubMed  Google Scholar 

  30. Ichimura T, Kondo S, Ambo Y, et al.: Primary sclerosing cholangitis associated with autoimmune pancreatitis. Hepatogastroenterology 2002, 49:1221–1224.

    PubMed  Google Scholar 

  31. Kamisawa T, Egawa N, Inokuma S, et al.: Pancreatic endocrine and exocrine function and salivary gland function in autoimmune pancreatitis before and after steroid therapy. Pancreas 2003, 27:235–238.

    Article  PubMed  CAS  Google Scholar 

  32. Kojima E, Kimura K, Noda Y, et al.: Autoimmune pancreatitis and multiple bile duct strictures treated effectively with steroid. J Gastroenterol 2003, 38:603–607.

    Article  PubMed  Google Scholar 

  33. Tanaka S, Kobayashi T, Nakanishi K, et al.: Corticosteroidresponsive diabetes mellitus associated with autoimmune pancreatitis. Lancet 2000, 356:910–911.

    Article  PubMed  CAS  Google Scholar 

  34. Kuroiwa T, Suda T, Takahashi T, et al.: Bile duct involvement in a case of autoimmune pancreatitis successfully treated with an oral steroid. Dig Dis Sci 2002, 47:1810–1816.

    Article  PubMed  Google Scholar 

  35. Imagawa A, Hanafusa T, Miyagawa J, Matsuzawa Y: A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. Osaka IDDM Study Group. N Engl J Med 2000, 342:301–307.

    Article  PubMed  CAS  Google Scholar 

  36. Imagawa A, Hanafusa T, Tamura S, et al.: Pancreatic biopsy as a procedure for detecting in situ autoimmune phenomena in type 1 diabetes: close correlation between serological markers and histological evidence of cellular autoimmunity. Diabetes 2001, 50:1269–1273.

    Article  PubMed  CAS  Google Scholar 

  37. Takayama M, Hamano H, Ochi Y, et al.: Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation. Am J Gastroenterol 2004, 99:932–937.

    Article  PubMed  Google Scholar 

  38. Furukawa N, Muranaka T, Yasumori K, et al.: Autoimmune pancreatitis: radiologic findings in three histologically proven cases. J Comput Assist Tomogr 1998, 22:880–883.

    Article  PubMed  CAS  Google Scholar 

  39. Irie H, Honda H, Baba S, et al.: Autoimmune pancreatitis: CT and MR characteristics. AJR Am J Roentgenol 1998, 170:1323–1327.

    PubMed  CAS  Google Scholar 

  40. Eerens I, Vanbeckevoort D, Vansteenbergen W, Van Hoe L: Autoimmune pancreatitis associated with primary sclerosing cholangitis: MR imaging findings. Eur Radiol 2001, 11:1401–1404.

    Article  PubMed  CAS  Google Scholar 

  41. Saegusa H, Momose M, Kawa S, et al.: Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis. Pancreas 2003, 27:20–25.

    Article  PubMed  Google Scholar 

  42. Nakamoto Y, Saga T, Ishimori T, et al.: FDG-PET of autoimmune-related pancreatitis: preliminary results. Eur J Nucl Med 1835, 27:1835–1838.

    Article  Google Scholar 

  43. Horiuchi A, Kawa S, Hamano H, et al.: ERCP features in 27 patients with autoimmune pancreatitis. Gastrointest Endosc 2002, 55:494–499.

    PubMed  Google Scholar 

  44. Kawa S, Hamano H: Autoimmune pancreatitis and bile duct lesions. J Gastroenterol 2003, 38:1201–1203.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, 55905, Rochester, MN, USA

    Suresh T. Chari MD

Authors
  1. Luis P. Lara MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suresh T. Chari MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lara, L.P., Chari, S.T. Autoimmune pancreatitis. Curr Gastroenterol Rep 7, 101–106 (2005). https://doi.org/10.1007/s11894-005-0047-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11894-005-0047-4

Keywords

Search

Navigation