Type 2 Autoimmune Pancreatitis (Idiopathic Duct-Centric Pancreatitis) Highlighting Patients Presenting as Clinical Acute Pancreatitis: A Single-Center Experience
- Author:
Dongwook OH
1
;
Tae Jun SONG
;
Sung Hoon MOON
;
Jin Hee KIM
;
Joo Nam LEE
;
Seung Mo HONG
;
Joune Seup LEE
;
Seok Jung JO
;
Dong Hui CHO
;
Do Hyun PARK
;
Sang Soo LEE
;
Dong Wan SEO
;
Sung Koo LEE
;
Myung Hwan KIM
Author Information
- Publication Type:Original Article
- Keywords: Autoimmune pancreatitis; Idiopathic duct-centric pancreatitis; Acute pancreatitis
- MeSH: Colitis, Ulcerative; Consensus; Far East; Follow-Up Studies; Gallstones; Humans; Jaundice, Obstructive; Korea; Pancreas; Pancreatic Ducts; Pancreatitis; Prevalence; Recurrence
- From:Gut and Liver 2019;13(4):461-470
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Type 2 autoimmune pancreatitis (AIP) has been considered extremely rare in East Asia. This study aimed to clarify the prevalence, clinical characteristics and radiological findings of type 2 AIP highlighting patients presenting as acute pancreatitis in a single center. METHODS: Type 2 AIP patients were classified according to International Consensus Diagnostic Criteria. Radiological findings were compared between type 2 AIP presenting as acute pancreatitis and gallstone pancreatitis. RESULTS: Among 244 patients with AIP, 27 (11.1%) had type 2 AIP (definite, 15 [55.5%] and probable 12 [44.5%]). The median age of patients with type 2 AIP was 29 years (interquartile range, 20 to 39 years). Acute pancreatitis was the most common initial presentation (n=17, 63%) while obstructive jaundice was present in only one patient. Ulcerative colitis (UC) was associated with type 2 AIP in 44.4% (12/27) of patients. Radiological pancreatic imaging such as delayed enhancement of diffusely enlarged pancreas, homogeneous enhancement of focal enlargement/mass, absent/minimal peripancreatic fat infiltration or fluid collection, and multifocal main pancreatic duct narrowings were helpful for differentiating type 2 AIP from gallstone pancreatitis. During follow-up (median, 32.3 months), two patients (2/25, 8%) experienced relapse. CONCLUSIONS: In South Korea, type 2 AIP is not as rare as previously thought. Overall, the clinical profile of type 2 AIP was similar to that of Western countries. Type 2 AIP should be considered in young UC patients with acute pancreatitis of uncertain etiology.
