Clinical characteristic of autoimmune pancreatitis: an analysis of 81 patients

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Author:
XIN Lei(Department of Gastroenterology, Changhai Hospital, Second Military Medical University,Shanghai 200433, China)
LI Zhao-shen(Department of Gastroenterology, Changhai Hospital, Second Military Medical University,Shanghai 200433, China)
PENG Guo-lin(Department of Gastroenterology, Changhai Hospital, Second Military Medical University,Shanghai 200433, China)
LIAO Zhuan(Department of Gastroenterology, Changhai Hospital, Second Military Medical University,Shanghai 200433, China)
HU Liang-hao(Department of Gastroenterology, Changhai Hospital, Second Military Medical University,Shanghai 200433, China)
CHANG Xue-jiao()
ZHU Ming-hua()
ZHENG Jian-ming()
PAN Chun-shu()
SHEN Qian()
Journal Title:
Chinese Journal of Pancreatology
Issue:
Volume 12, Issue 05, 2012
DOI:
10.3760/cma.j.issn.1674-1935.2012.05.002
Key Word:
Pancreatitis, autoimmune; Pancreatitis, chronic ; Disease attributes ; Immunoglobulin G4; Lymphoplasmacytic sclerosing pancreatitis

Abstract: Objective To analyze the clinical characteristic of Chinese autoimmune pancreatitis (AIP) patients.Methods All clinical data of 81 patients with a diagnosis of AIP in Shanghai Changhai Hospital from February 2005 to May 2012 were analyzed.Results The sex ratio was 7.1∶1 and the mean age was (57± 12) years old in 81 patients with AIP.Obstructive jaundice was the initial symptom in 51.9% (42/81) patients.In patient receiving CT,focal and diffuse type accounted for 45 and 35 patients.respectively,and pseudocyst was the main manifestation in 1 patient,biliary tract was involved in 59(72.8% ) patients,dilatation of main pancreatic duct was observed in 5 ( 11.1% ) patients.In patients receiving PET-CT,diffuse increased Flourine-18 FDG uptake by the pancreas was found in 11 patients,focal increased uptake in 2patients,and significant extra-pancreatic uptake was found in 5 patients.The positive rate of serum IgG4,CA19-9,ss DNA,anti-nuclear antibody and ds-DNA antibody was 94.6% (53/81),54.4% (37/68),14.3% (4/28),10.7% (3/28),7.1% (2/28),respectively.The pathological findings of H-E staining and IgG4 immunohistochemical analysis in 20 patients were consistent with lymphoplasmacytic sclerosing pancreatitis.Conclusions Type 1 AIP is the main subtype of AIP in China.Combining clinical symptoms,extra-pancreatic manifestations,imaging or nuclear medicine findings,serology,cytology or histology can effectively increase the correct diagnosis rate of AIP.

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