TY - JOUR
T1 - Autoimmune pancreatitis as a new clinical entity
T2 - Three cases of autoimmune pancreatitis with effective steroid therapy
AU - Ito, Tetsuhide
AU - Nakano, Itsuro
AU - Koyanagi, Shujiro
AU - Miyahara, Toshihiko
AU - Migita, Yoshikatsu
AU - Ogoshi, Keiichiro
AU - Sakai, Hironori
AU - Matsunaga, Shizu
AU - Yasuda, Osamu
AU - Sumii, Toshihiko
AU - Nawata, Hajime
N1 - Funding Information:
This study was supported by the Research Committee on Intractable Diseases of the Pancreas of the Japanese Ministry of Health and Welfare, and by a Grant in-aid for GeneralScienti® cResearchfromtheMinistryofEduca-tion, Science and Culture of Japan.
PY - 1997
Y1 - 1997
N2 - The most common forms of chronic pancreatitis are related to alcohol ingestion, whereas the entity of non-alcohol-associated (idiopathic) pancreatitis is poorly understood. Autoimmunity has been suggested as a possible etiologic factor of idiopathic chronic pancreatitis. A total of 362 Japanese patients underwent endoscopic retrograde pancreatography (ERP) for suspected pancreatic disease, and 161 were diagnosed with chronic pancreatitis. Among them, we found three cases (1.86% incidence) of unique chronic pancreatitis, in which ERP revealed diffuse narrowing of the main pancreatic duct with an irregular wall. We diagnosed these three patients as having pancreatitis associated with an autoimmune mechanism morphologically and biochemically and started them on steroid therapy. The characteristics of the these three patients were as follows: hypergammaglobulinemia, eosinophilia, ultrasonography showing hypoehoic diffuse swelling in the pancreas (sausage-like appearance), ERP showing diffuse narrowing of the main pancreatic duct with irregular like thumbprint-like marks, reversible exocrine insufficiency, and positive anti-carbonic anhydrase II antibody. After one month of the treatment with steroids, pancreatitis dramatically improved morphologically and enzymatically. Here we describe these cases of the suspected autoimmune chronic pancreatitis. We must recognize the concept and the features of autoimmune pancreatitis in order to avoid unnecessary surgery as pancreatic cancer.
AB - The most common forms of chronic pancreatitis are related to alcohol ingestion, whereas the entity of non-alcohol-associated (idiopathic) pancreatitis is poorly understood. Autoimmunity has been suggested as a possible etiologic factor of idiopathic chronic pancreatitis. A total of 362 Japanese patients underwent endoscopic retrograde pancreatography (ERP) for suspected pancreatic disease, and 161 were diagnosed with chronic pancreatitis. Among them, we found three cases (1.86% incidence) of unique chronic pancreatitis, in which ERP revealed diffuse narrowing of the main pancreatic duct with an irregular wall. We diagnosed these three patients as having pancreatitis associated with an autoimmune mechanism morphologically and biochemically and started them on steroid therapy. The characteristics of the these three patients were as follows: hypergammaglobulinemia, eosinophilia, ultrasonography showing hypoehoic diffuse swelling in the pancreas (sausage-like appearance), ERP showing diffuse narrowing of the main pancreatic duct with irregular like thumbprint-like marks, reversible exocrine insufficiency, and positive anti-carbonic anhydrase II antibody. After one month of the treatment with steroids, pancreatitis dramatically improved morphologically and enzymatically. Here we describe these cases of the suspected autoimmune chronic pancreatitis. We must recognize the concept and the features of autoimmune pancreatitis in order to avoid unnecessary surgery as pancreatic cancer.
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U2 - 10.1023/A:1018862626221
DO - 10.1023/A:1018862626221
M3 - Article
C2 - 9246047
AN - SCOPUS:8544274485
SN - 0163-2116
VL - 42
SP - 1458
EP - 1468
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 7
ER -
