The Therapeutic Strategy for Autoimmune Pancreatitis Is Subject to Endoscopic Features of the Duodenal Papilla

Kubota, Kensuke; Kato, Shingo; Kobayashi, Noritoshi; Nakajima, Atsushi

doi:10.1016/j.gie.2009.03.141

Cited by 2 publications

(4 citation statements)

References 14 publications

(28 reference statements)

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“…In addition, ductal dilatation, calciﬁcations and proteinaceous plugs are absent[ 6 ]. Biopsy of extrapancreatic sites, including the bile ducts and major duodenal papilla, may also facilitate the diagnosis[ 12 20 ].…”

Section: Discussionmentioning

confidence: 99%

Autoimmune pancreatitis mimicking pancreatic cancer

et al. 2011

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Context:Autoimmune pancreatitis is a particular type of pancreatitis of presumed autoimmune etiology, it is an entity distinct from all others forms of chronic pancreatitis, characterized by clinical, histopathological, radiographic, serologic and therapeutic features. This benign disease resembles pancreatic carcinoma both clinically and radiographically.Case Report:A 27-year-old man presented with obstructive jaundice and evocative image of pancreatic tumor. A pancreaticoduodenectomy (Whipple operation) was performed and pathological examination of the specimen diagnosed AIP. Patient responded well to a course of corticosteroids with resolution of clinical and biological disorders.Conclusion:Accurate and timely diagnosis of autoimmune pancreatitis is particularly important because steroid therapy is effective and pancreatic resection is not necessary.

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Section: Discussionmentioning

confidence: 99%

Autoimmune pancreatitis mimicking pancreatic cancer

et al. 2011

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“…We also indicated that the features of the duodenal papilla could not only influence the diagnosis of AIP but could have a prognostic value. We believe that the therapeutic strategy can be subject to the features of the duodenal papilla [Kubota et al 2009b]. …”

Section: Pathogenesismentioning

confidence: 99%

“…We retrospectively analyzed the clinicopathological features of AIP patients who exhibited spontaneous remission and/or relapse in an attempt to identify the relapse-related risk factors in AIP [Kubota et al 2009b]. Regarding spontaneous remission, patients who entered remission without corticosteroid therapy had a better outcome without relapse in the study.…”

Section: Treatment and Prognostic Factorsmentioning

confidence: 99%

“…A proposed therapeutic strategy of duodenal papillitis associated with autoimmune pancreatitis: results summary The standard steroid therapy for AIP has been proposed, however, the factors related to spontaneous remission and relapse have not been fully evaluated from the viewpoint of the features of endoscopic duodenal papilla. We retrospectively analyzed the clinicopathological features of AIP patients who exhibited spontaneous remission and/or relapse in an attempt to identify the relapse-related risk factors in AIP [Kubota et al 2009b]. Regarding spontaneous remission, patients who entered remission without corticosteroid therapy had a better outcome without relapse in the study.…”

Section: Treatment and Prognostic Factorsmentioning

confidence: 99%

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The therapeutic strategy for autoimmune pancreatitis is subject to the endoscopic features of the duodenal papilla

Kubota

Nakajima

2010

Therap Adv Gastroenterol

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Autoimmune pancreatitis (AIP) often presents with a swollen duodenal papilla, however, the clinical significance of the duodenal papilla in AIP has not been fully elucidated. Data have shown swollen duodenal papillae shaped like a pear and/or with a submucosal tumor having IgG4-bearing plasma cells. Immunohistopathology has potentially verified duodenal papillitis associated with AIP. FOXP3-positive lymphocytes are also recognized in AIP. AIP has shown spontaneous remission and relapse irrelevance to corticosteroid therapy. The results of a multivariate analysis revealed the absence of a swollen duodenal papilla as the only significant independent factor predictive of spontaneous remission in AIP cases. In addition, the results of another multivariate analysis revealed the presence of a swollen duodenal papilla and the presence of extrapancreatic lesions as the significant independent factors predictive of relapse in these cases. Results suggest that the lack of a swollen duodenal papilla is a predictive factor for spontaneous remission, and thus negates the need to administer corticosteroids in those AIP patients. In contrast, a swollen duodenal papilla and the presence of extrapancreatic lesions are risk factors for relapse, and those AIP patients are candidates for maintenance corticosteroid therapy to reduce relapse. Therefore, the therapeutic strategy such as the indication for corticosteroid administration is subject to the endoscopic features of the duodenal papilla.

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The Therapeutic Strategy for Autoimmune Pancreatitis Is Subject to Endoscopic Features of the Duodenal Papilla

Cited by 2 publications

References 14 publications

Autoimmune pancreatitis mimicking pancreatic cancer

Autoimmune pancreatitis mimicking pancreatic cancer

The therapeutic strategy for autoimmune pancreatitis is subject to the endoscopic features of the duodenal papilla

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