Clinical features of autoimmune pancreatitis: a case series of 16 patients
10.3760/cma.j.issn.1674-1935.2010.03.002
- VernacularTitle:自身免疫性胰腺炎16例的临床分析
- Author:
Hong LV
;
Weizhong JIANG
;
Jiaming QIAN
;
Aiming YANG
;
Mingwei QIN
;
Huijun SHU
;
Hui DING
- Publication Type:Journal Article
- Keywords:
Pancreatitis,chronic;
Pancreatitis,autoimmune;
Diagnosis;
Therapy
- From:
Chinese Journal of Pancreatology
2010;10(3):155-158
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical features, diagnosis and treatment of autoimmune pancreatitis (AIP). Methods From March 2003 to January 2008, a total of 16 cases of AIP were reviewed retrospectively. Results The ratio of male: female was 15:1, with a mean age of 61 years old (range:47-79 years old). Jaundice was the main clinical presentation in 81.2% patients. 68.8% patients presented with high serum gammaglobulin, while 66.7% with high serum IgG, 56.2% with elevated ESR, 50.0% with positive rheumatoid factor(RF), 43.7% with eosinophilia, 26.7% with positive antinuclear antigen(ANA),31.2% with elevated lipase, 18.7% with elevated amylase, and 25.0% with elevated CA19-9. 93.7%patients showed diffuse swelling of the pancreas on CT and/or endoscopic ultrasound. Stricture of the main pancreatic duct was seen in 100% patients. Distal common bile duct stricture was seen in 87.5%, while thickened wall of bile duct was seen in 50%. Histological findings of the pancreas EUS-FNA showed nonspecific results in one patient, while no tumor cell was detected in other 5 patients; lymphocytes infiltration was noted in 3 patients; pancreatic fibrosis was seen in 2 patients. 75.0% patients was found to have diabetes or abnormal sugar tolerance, enlargement of the celiac lymph nodes in 43.7%, splenic vein or inferior cava vein involvement in 42.9%, swelling of the maxillary glands in 18.7%, the lacrimal glands in 12%. Prednisone was given to 11 patients, among them 5 patients underwent endoscopic stent placement, and 10 patients responded well while 1 patient discontinued therapy due to intolerance. 2 patients underwent endoscopic stent placement alone and jaundice disappeared. 3 patients received conventional medical treatment. Steroid therapy exerted different effects on levels of the blood glucose, the enlarged maxillary and lacrimal glands improved after steroid therapy. Conclusions AIP occurred in middle aged and senior male predominantly, painless obstructive jaundice was the main clinical presentation, and patients may be accompanied with elevated levels of IgG, hypergammaglobulin, positive RF and ANA, diffuse or focal pancreatic enlargement, pancreatic duct stricture and distal common bile duct stricture. Stent placement could improve the symptoms, and steroid therapy was effective.
