Recurrent Attacks of Autoimmune Pancreatitis Result in Pancreatic Stone Formation

Abstract

Contrary to previous reports, we observed both relapse and pancreatic stone formation in some patients with autoimmune pancreatitis, which suggests that autoimmune pancreatitis has the potential to be a progressive disease with pancreatic stones.

Long-Term Follow-Up of Autoimmune Pancreatitis: Characteristics of Chronic Disease and Recurrence

“…Accordingly, pancreatic stone formation was judged to be closely associated with recurrence. 2 Previous studies investigated the recurrence of AIP, but they reported lower recurrence rates, ranging from 6 to 23 %. [5][6][7] Though the exact reasons for these discrepancies are unclear, they may be related to the number of patients, the follow-up periods, and the type of corticosteroid therapy may be related.…”

“…2 The observation periods were 24-178 months (mean 72 months). Corticosteroid therapy was administered to 42 patients.…”

“…2,6 Incomplete obstruction of the main pancreatic duct system and the stasis of pancreatic juice may give rise to the formation of pancreatic stones. The finding of irregular narrowing or stricture of the main pancreatic duct in patients with AIP provided further support for this potential mechanism.…”

The role of Movat pentachrome stain and immunoglobulin G4 immunostaining in the diagnosis of autoimmune pancreatitis

“…It often leads to unnecessary surgical resection, [1][2][3][4] which is particularly tragic given that this entity is now known to be rapidly and effectively treated by corticosteroid therapy. [5][6][7][8][9] Accordingly, preoperative biopsy diagnosis and medical treatment are highly sought after clinical goals. This study sheds further light on the issue by demonstrating the utility of two histologic features in combination, namely venous pathology as detected by Movat staining, in conjunction with increased pancreatic tissue IgG4-positive plasma cells by immunohistochemistry.…”

“…3,4 Steroid therapy has been shown to be highly and rapidly effective in the majority of cases, leading to resolution within weeks of pancreatic mass lesions, pancreatic and biliary obstruction, and symptoms of pain and pancreatic insufficiency. [5][6][7][8][9] Until recently, preoperative diagnosis and medical therapy were not available options, but emerging clinical and pathologic assays are changing this situation. The obvious therapeutic advantage of accurate diagnosis is critical and indicates the need for highly sensitive and specific markers.…”