Clinical Characteristics of 327 Asian Patients With Autoimmune Pancreatitis Based on Asian Diagnostic Criteria

Kamisawa, Terumi; Kim, Myung Hwan; Liao, Wei‐Chih; Liu, Quanda; Balakrishnan, Vallath; Okazaki, Kazuichi; Shimosegawa, Tooru; Chung, Jae Bock; Lee, Kyu Taek; Wang, Hsiu Po; Lee, Tsung Chun; Choudhuri, Gourdas

doi:10.1097/mpa.0b013e3181fab696

Cited by 95 publications

(62 citation statements)

References 21 publications

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“…The lesion in pancreas and other organs in are characterized by lymphocytic infiltrate on a background of fibrosis morphologically similar to that seen in a case of idiopathic orbital inflammation [2,3]. IgG4 mainly affects men older than 50 years of age with a sex ratio of 3.7 to 5.7:1 [4]. The age of our patient also corresponds with this age but incidence in female is uncommon.…”

Section: Discussionmentioning

confidence: 68%

IgG4 Related Disease-The Great Masquerade

Ete¹,

Mondal²,

Sinha³

et al. 2014

JCR

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Abstract:IgG4 related disease is an uncommon disease that presents with diverse clinical manifestations. Interestingly the disease is a great masquerade of many other autoimmune and malignant conditions. Rare occurrence and varied clinical phenotype makes this disease a challenging one for the clinicians. Here we present a case of IgG4 related disease in a 50 year old female, who initially presented with low grade fever, sicca symptoms, eyelid swelling with proptosis along with bilateral salivary gland enlargement. Final diagnosis was made from characteristic histopathological finding and markedly elevated serum IgG4 level.

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Section: Discussionmentioning

confidence: 68%

IgG4 Related Disease-The Great Masquerade

Ete¹,

Mondal²,

Sinha³

et al. 2014

JCR

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“…Prevalence of type II AIP is less both in USA, Asia as compared to Italian series. There were only 5 cases of histologically confirmed cases of IDCP in the Asian mult-icentre trial (4 cases from Korea and 1 from Japan) and were not doi: 10.7243/2055-091X-1-11 included in their study [19]. Frequency of this subtype in USA is also infrequent.…”

Section: Discussionmentioning

confidence: 99%

“…Since there was paucity of data from Asian countries, a multicentre trial was conducted where 10 centers from Japan. China, Korea, Taiwan and India pooled their data [18,19]. It was questionnaire based data collection using Asian diagnostic criteria and a total of 327 AIP cases were identified.…”

Section: Discussionmentioning

confidence: 99%

Title-autoimmune pancreatitis in pancreatic resections done for presumed pancreatic malignancies-An experience of tertiary centre from North India

Nada¹,

Gupta²,

Bhasin³

et al. 2014

J Histol Histopathol

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Background: Autoimmune pancreatitis (AIP) can present as pancreatic mass mimicking malignancy. However, it has specific histomorphology and immunohistology which in clinical context can be diagnostic. Aim: To retrospectively analyze pancreatic resections done for pancreatic head masses to identify cases of autoimmune pancreatitis. Methods: Hematoxylin and eosin stained slides of pancreatic resections (n-142) done for pancreatic masses (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) were reviewed. Immunohistochemistry for IgG4 was done in cases suggestive of AIP. As controls, 30 pancreatic carcinomas (n-30) and plasma cells rich chronic pancreatitis (n-25) were stained with IgG4. Clinical records were retrieved. Results: There were 5/142 cases (3.5%) of autoimmune pancreatitis among pancreatic resections done for presumed pancreatic tumors. There were 3 females and 2 males and age range was 35-65 (mean 51). Presenting symptoms were painless jaundice (n-4), with adult onset diabetes (n-1) and feature of gastric outlet obstruction (n-1). Histomorphology of all the five masses was of Type I autoimmune pancreatitis showing lobulocentric plasma cell rich inflammation and storiform fibrosis. IgG4 positive plasma cells (>10 per high power field) in all the cases diagnosed as autoimmune pancreatitis; though few IgG4 positive plasma cells were positive in controls. Venulitis and veno-oblitrative changes, neural hyperplasia, neuritis were present in all. Serum IgG4 levels done immediately after surgeries in three patients were elevated. Conclusion: Incidence of autoimmune pancreatitis in pancreatic resections done for pancreatic masses is 3.5%. All the five cases were of Type 1 autoimmune pancreatitis with significant number of IgG4 positive plasma cells using >10 positive cells per high power field as cut off.

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“…Four months after surgery, the patient was readmitted because of reoccurrence of atitis characterized by prominent lymphocyte infiltration and pancreatic fibrosis resulting in organ dysfunction [1] . This disease has been mainly reported in Japan and Europe with an estimated incidence of 4%-6% among chronic pancreatitis patients [2,3] . In China, only a few AIP cases have been reported even though approximately 5% of chronic pancreatitis cases resulted from autoimmuneassociated responses [4] .…”

Section: Introductionmentioning

confidence: 99%

Autoimmune pancreatitis characterized by predominant CD8+ T lymphocyte infiltration

Li¹

2011

WJG

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severe jaundice and sustained abdominal distension. Prednisone 30 mg/d was administered orally as an AIP was suspected. One and a half months later, the symptoms of the patient disappeared, and globulin, aminotransferase and bilirubin levels decreased significantly. Over a 9-mo follow-up period, the dose of prednisone was gradually decreased to 10 mg/d and the patient remained in good condition. We further demonstrated dominant CD3+/CD8+ populations, CD20+ cells and a few CD4+ cells in the pancreatic parenchyma, duodenum and gallbladder wall by immunohistochemical assay. This AIP case presented with significant CD8+ T lymphocyte infiltration in the pancreas and extra-pancreatic lesions, indicating that this cell population may be more important in mediating AIP pathogenesis than previously known and that AIP might be a poorly defined autoimmune disease with heterogeneous pathogenesis.

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Clinical Characteristics of 327 Asian Patients With Autoimmune Pancreatitis Based on Asian Diagnostic Criteria

Abstract: Features of AIP are fundamentally similar in Japan, Korea, Taiwan, and China. Knowledge of emerging AIP should be more widespread in Asia to avoid unnecessary operation.

Cited by 95 publications

References 21 publications

IgG4 Related Disease-The Great Masquerade

IgG4 Related Disease-The Great Masquerade

Title-autoimmune pancreatitis in pancreatic resections done for presumed pancreatic malignancies-An experience of tertiary centre from North India

Autoimmune pancreatitis characterized by predominant CD8+ T lymphocyte infiltration

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