Analysis on the clinical characteristics of autoimmune pancreatitis patients from 2009 to 2018 in China
10.3760/cma.j.cn115667-20200217-00018
- VernacularTitle:2009年至2018年我国自身免疫性胰腺炎患者临床特征分析
- Author:
Dan WU
1
;
Qiu QIU
;
Liang TANG
;
Kaijun LIU
;
Dongfeng CHEN
Author Information
1. 陆军军医大学大坪医院消化内科，重庆 400042
- From:
Chinese Journal of Pancreatology
2020;20(5):368-372
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze and summarize the clinical characteristics of autoimmune pancreatitis (AIP) patients in China from 2009 to 2018.Methods:Studies published from January 2009 to December 2018 were searched in CNKI, Wanfang and VIP databases by using " autoimmune pancreatitis" , " immune pancreatitis" and " IgG related pancreatitis" as search items, respectively. One hundred and ten articles were finally included, and a total of 2 364 AIP patients were involved. The gender, age, clinical manifestations, laboratory tests, radiological examination, treatment and prognosis of these AIP patients were analyzed and summarized.Results:Among the 2 364 AIP patients, there were 1 777 males and 587 females, with an average age of 58 years. The main clinical manifestations were jaundice(61.31%), abdominal pain(52.45%), abdominal discomfort(34.78%) and body weight loss(22.62%). 50.13% of the patients suffered from extrapancreatic manifestations. Serological examination detected significantly increased levels of IgG4 (74.14%), CRP (73.68%), IgG (71.41%), erythrocyte sedimentation (67.34%), total bilirubin (62.44%), ALT/AST(50.83%), CA19-9(43.85%) and positive rheumatoid factor (42.04%). Pancreatic diffuse (46.87%) and regional enlargement (21.87%) was found in AIP patients by imaging examination. The pancreatic pathological manifestations mainly included lymphoplasmic cell infiltration, pancreatic acinar destruction and atrophy, fibrous tissue proliferation, and positive IgG4 deposition by immunohistochemistry. 282 patients (11.92%) were misdiagnosed, while 70.12% of AIP patients were attenuated by hormones therapies.Conclusions:AIP, which is more common in male in China, is often accompanied by extrapancreatic manifestations. Although imaging examinations were helpful for diagnosis, the misdiagnosis rate remains high. Clinicians need to raise awareness, enhance the ability to diagnose and treat AIP, thus reducing misdiagnosis.
