Research Progress Of Autoimmune Pancreatitis

BackgroundAutoimmune pancreatitis (AIP) is a distinct form of chronic pancreatitis and was named by Japanese scholars in 1995. AIP is the pancreatic manifestation of an IgG4-related disease with elevated IgG4 serum levels, infiltration of lymphoplasmacytic plasma cells and extrapancreatic lesions. AIP has attracted attention at home and abroad in the recent yearsbut owing to the low incidence of AIP that is rare being reported and clinical image findings misdiagnosed as pancreatic cancer easily. Therefore, further understanding of AIP needs to improve to prompt diagnosis and appropriate treatment.ObjectiveAnalyzing the clinical and image characteristics of AIP, observing the treatment responses, to raise awareness of the disease.MethodsReport one case of AIP patient who was diagnosed and treated in China-Japan Friendship Hospital by the means of analysis. We retrieve and review the articles related to AIP in the PubMed database, China National Knowledge Infrastructure, Wanfang database method.ResultsWe report the case of a 54-year-old male with a history of jaundice for twenty days prior to his hospital visit. Image findings such as abdominal CT, MRI/MRCP, EUS, confirmed diffuse enlargement of the pancreas, dilatation in the intra-and extra-hepatic bile ducts and narrow intrapancreatic biliary. Laboratory analyses showed increased levels of IgG4 (1000mg/dl) with abnormal function of liver. It is diagnosed with AIP by the combination of gender, the age of onset, clinical image findings and laboratory analyses. Image findings and liver function improved after treatment of prednisone 40mg/d for two weeks and prednisone was decreased 5mg every two weeks afterwards. Serum IgG4 (554mg/dl) decreased significantly with pancreatic morphology and function of liver almost near normal after six weeks of prednisone therapy in the recent follow-up.ConclusionsAIP is characterized by enlargement of the pancreas, irregular narrowing of the main pancreatic duct, elevating levels of serum IgG4. As long as we are familiar with the clinical and imaging characteristics of AIP in clinical work, It is not difficult to diagnose a typical AIP with predictable response to corticosteroid therapy.