Abstract
Autoimmune chronic pancreatitis (AIP) is a clinically attractive entity because of its dramatic response to oral steroid therapy. Recently, as awareness of AIP is increasing, more cases are being reported. However, there are still no established worldwide diagnostic criteria for AIP. Since the Japan Pancreas Society (JPS) published diagnostic criteria for autoimmune chronic pancreatitis in the year 2002, increased attention toward this relatively new disease entity has enabled more cases of AIP to be correctly diagnosed. As previously unrecognized or misdiagnosed cases of autoimmune chronic pancreatitis are found, an increasing number of cases that are not in full accordance with the JPS diagnostic criteria are revealed. As a result, some groups have developed and cited their own criteria in the reporting of autoimmune chronic pancreatitis. The absence of consistent, uniform criteria has made comparison of different cases diagnosed under various guidelines difficult.
In this review, we discuss and compare the four current sets of diagnostic criteria, focusing on their individual strengths and weaknesses.
Similar content being viewed by others
References
K Yoshida F Toki T Takeuchi S Watanabe K Shiratori N Hayashi (1995) ArticleTitleChronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis Dig Dis Sci 40 1561–8 Occurrence Handle7628283 Occurrence Handle10.1007/BF02285209 Occurrence Handle1:STN:280:DyaK2MzlsVCqtg%3D%3D
T Ito I Nakano S Koyanagi T Miyahara Y Migita K Ogoshi et al. (1997) ArticleTitleAutoimmune pancreatitis as a new clinical entity. Three cases of autoimmune pancreatitis with effective steroid therapy Dig Dis Sci 42 1458–68 Occurrence Handle9246047 Occurrence Handle10.1023/A:1018862626221 Occurrence Handle1:STN:280:DyaK2szovVyitg%3D%3D
K Okazaki T Chiba (2002) ArticleTitleAutoimmune-related pancreatitis Gut 51 1–4 Occurrence Handle12077078 Occurrence Handle10.1136/gut.51.1.1 Occurrence Handle1:STN:280:DC%2BD38zjtl2rtA%3D%3D
K Okazaki (2003) ArticleTitleAutoimmune pancreatitis is increasing in Japan Gastroenterology 125 1557–8 Occurrence Handle14628815 Occurrence Handle10.1016/j.gastro.2003.09.011
KP Kim MH Kim SS Lee DW Seo SK Lee (2004) ArticleTitleAutoimmune pancreatitis: it may be a worldwide entity Gastroenterology 126 1214 Occurrence Handle15057766 Occurrence Handle10.1053/j.gastro.2004.02.044
R Sutton (2005) ArticleTitleAutoimmune pancreatitis: also a Western disease Gut 54 581–3 Occurrence Handle15831898 Occurrence Handle10.1136/gut.2004.058438 Occurrence Handle1:STN:280:DC%2BD2M7pslynsA%3D%3D
InstitutionalAuthorNameMembers of the Criteria Committee for Autoimmune Pancreatitis of the Japan Pancreas Society (2002) ArticleTitleDiagnostic criteria for autoimmune pancreatitis by the Japan Pancreas Society J Jpn Pancreas Soc 17 585–7
RK Pearson DS Longnecker ST Chari TC Smyrk K Okazaki L Frulloni et al. (2003) ArticleTitleControversies in clinical pancreatology. Autoimmune pancreatitis: does it exist? Pancreas 27 1–13 Occurrence Handle12826899 Occurrence Handle10.1097/00006676-200307000-00001
KP Kim MH Kim JC Kim SS Lee DW Seo SK Lee et al. (2006) ArticleTitleDiagnostic criteria for autoimmune chronic pancreatitis revisited World J Gastroenterol 12 2487–96 Occurrence Handle16688792
EK Choi MH Kim JC Kim JM Han DW Seo SS Lee et al. (2006) ArticleTitleThe Japanese diagnostic criteria for autoimmune chronic pancreatitis: is it completely satisfactory? Pancreas 33 13–9 Occurrence Handle16804407 Occurrence Handle10.1097/01.mpa.0000222318.59360.68
ST Chari TC Smyrk MJ Levy MD Topazian N Takahashi L Zhang et al. (2006) ArticleTitleDiagnosis of autoimmune pancreatitis: the Mayo Clinic experience Clin Gastroenterol Hepatol 4 1010–6 Occurrence Handle16843735 Occurrence Handle10.1016/j.cgh.2006.05.017
N Abe M Sugiyama Y Atomi (2002) ArticleTitleIssues related to the diagnosis and treatment of autoimmune pancreatitis J Jpn Pancreas Soc 17 636–40
KP Kim MH Kim YJ Lee MH Song DH Park SS Lee et al. (2004) ArticleTitleClinical characteristics of 17 cases of autoimmune chronic pancreatitis Korean J Gastroenterol 43 112–9 Occurrence Handle14978368
KP Kim MH Kim MH Song SS Lee DW Seo SK Lee (2004) ArticleTitleAutoimmune chronic pancreatitis Am J Gastroenterol 99 1605–16 Occurrence Handle15307882 Occurrence Handle10.1111/j.1572-0241.2004.30336.x
H Irie H Honda S Baba T Kuroiwa K Yoshimitsu T Tajima et al. (1998) ArticleTitleAutoimmune pancreatitis: CT and MR characteristics Am J Roentgenol 170 1323–7 Occurrence Handle1:STN:280:DyaK1c3jtlOqtQ%3D%3D
C Procacci G Carbognin C Biasiutti L Frulloni E Bicego E Spoto et al. (2001) ArticleTitleAutoimmune pancreatitis: possibilities of CT characterization Pancreatology 1 246–53 Occurrence Handle12120203 Occurrence Handle10.1159/000055819 Occurrence Handle1:STN:280:DC%2BD38znsVGrtQ%3D%3D
EJ Balthazar (2002) ArticleTitleAcute pancreatitis: assessment of severity with clinical and CT evaluation Radiology 223 603–13 Occurrence Handle12034923 Occurrence Handle10.1148/radiol.2233010680
DV Sahani SP Kalva J Farrell MM Maher S Saini PR Mueller et al. (2004) ArticleTitleAutoimmune pancreatitis: imaging features Radiology 233 345–52 Occurrence Handle15459324 Occurrence Handle10.1148/radiol.2332031436
DH Yang KW Kim TK Kim SH Park SH Kim MH Kim et al. (2006) ArticleTitleAutoimmune pancreatitis: radiologic findings in 20 patients Abdom Imaging 31 94–102 Occurrence Handle16333694 Occurrence Handle10.1007/s00261-005-0047-8 Occurrence Handle1:STN:280:DC%2BD28%2FhsFGjsA%3D%3D
F Toki T Nishino H Oyama L Karasawa K Shiratori I Oi (2002) ArticleTitleDiagnosis of autoimmune pancreatitis: imaging criteria J Jpn Pancreas Soc 17 598–606
T Kamisawa N Egawa H Nakajima K Tsuruta A Okamoto N Kamata (2003) ArticleTitleClinical difficulties in the differentiation of autoimmune pancreatitis and pancreatic carcinoma Am J Gastroenterol 98 2694–9 Occurrence Handle14687819 Occurrence Handle10.1111/j.1572-0241.2003.08775.x
E Shemesh A Czerniak S Nass E Klein (1990) ArticleTitleRole of endoscopic retrograde cholangiopancreatography in differentiating pancreatic cancer coexisting with chronic pancreatitis Cancer 65 893–6 Occurrence Handle2297660 Occurrence Handle10.1002/1097-0142(19900215)65:4<893::AID-CNCR2820650412>3.0.CO;2-G Occurrence Handle1:STN:280:DyaK3c7isVWmsA%3D%3D
A Horiuchi S Kawa H Hamano M Hayama H Ota K Kiyosawa (2002) ArticleTitleERCP features in 27 patients with autoimmune pancreatitis Gastrointest Endosc 55 494–9 Occurrence Handle11923760
K Inoue J Ohuchida T Ohtsuka T Nabae K Yokohata Y Ogawa et al. (2003) ArticleTitleSevere localized stenosis and marked dilatation of the main pancreatic duct are indicators of pancreatic cancer instead of chronic pancreatitis on endoscopic retrograde balloon pancreatography Gastrointest Endosc 58 510–5 Occurrence Handle14520282 Occurrence Handle10.1067/S0016-5107(03)01962-X
T Fujii A Yoshida N Yanagawa (2005) ArticleTitleSignificance of IgG4 measurement in patients with autoimmune pancreatitis Pancreas 31 2
T Wakabayashi Y Kawaura Y Satomura T Fujii Y Motoo T Okai et al. (2002) ArticleTitleClinical study of chronic pancreatitis with focal irregular narrowing of the main pancreatic duct and mass formation: comparison with chronic pancreatitis showing diffuse irregular narrowing of the main pancreatic duct Pancreas 25 283–9 Occurrence Handle12370540 Occurrence Handle10.1097/00006676-200210000-00011
Y Koga K Yamaguchi A Sugitani K Chijiiwa M Tanaka (2002) ArticleTitleAutoimmune pancreatitis starting as a localized form J Gastroenterol 37 133–7 Occurrence Handle11871765 Occurrence Handle10.1007/s005350200009
T Taniguchi H Tanio S Seko O Nishida F Inoue M Okamoto et al. (2003) ArticleTitleAutoimmune pancreatitis detected as a mass in the head of the pancreas without hypergammaglobulinemia, which relapsed after surgery: case report and review of the literature Dig Dis Sci 48 1465–71 Occurrence Handle12924637 Occurrence Handle10.1023/A:1024743218697
D Yadav K Notahara TC Smyrk JE Clain RK Pearson MB Farnell et al. (2003) ArticleTitleIdiopathic tumefactive chronic pancreatitis: clinical profile, histology, and natural history after resection Clin Gastroenterol Hepatol 1 129–35 Occurrence Handle15017505 Occurrence Handle10.1053/cgh.2003.50016
M Takayama H Hamano Y Ochi H Saegusa K Komatsu T Muraki et al. (2004) ArticleTitleRecurrent attacks of autoimmune pancreatitis results in pancreatic stone formation Am J Gastroenterol 99 932–7 Occurrence Handle15128363 Occurrence Handle10.1111/j.1572-0241.2004.04162.x
GA Lehman (2002) ArticleTitleRole of ERCP and other endoscopic modalities in chronic pancreatitis Gastrointest Endosc 56 S237–40 Occurrence Handle12447274 Occurrence Handle10.1016/S0016-5107(02)70018-7
EM Remer ME Baker (2002) ArticleTitleImaging of chronic pancreatitis Radiol Clin N Am 40 1229–42 Occurrence Handle12479708 Occurrence Handle10.1016/S0033-8389(02)00044-1
H Hamano S Kawa A Horiuchi H Unno N Furuya T Akamatsu et al. (2001) ArticleTitleHigh serum IgG4 concentrations in patients with sclerosing pancreatitis N Engl J Med 344 732–8 Occurrence Handle11236777 Occurrence Handle10.1056/NEJM200103083441005 Occurrence Handle1:CAS:528:DC%2BD3MXitFamt7k%3D
S Kawa H Hamano (2003) ArticleTitleAssessment of serological markers for the diagnosis of autoimmune pancreatitis J Jpn Pancreas Soc 17 607–10
I Nishimori S Kawa A Horiuchi H Unno N Furuya T Akamatsu et al. (2005) ArticleTitleHigh serum IgG4 concentrations in patients with sclerosing pancreatitis Gut 54 274–81 Occurrence Handle15647194 Occurrence Handle10.1136/gut.2004.049064 Occurrence Handle1:CAS:528:DC%2BD2MXhsVagt7o%3D
T Kamisawa A Okamoto N Funata (2005) ArticleTitleClinicopathological features of autoimmune pancreatitis in relation to elevation of serum IgG4 Pancreas 31 28–31 Occurrence Handle15968244 Occurrence Handle10.1097/01.mpa.0000167000.11889.3a Occurrence Handle1:CAS:528:DC%2BD2MXmvVamtLs%3D
L Frulloni P Bovo S Brunelli B Vaona V Di Francesco I Nishimori et al. (2000) ArticleTitleElevated serum levels of antibodies to carbonic anhydrase I and II in patients with chronic pancreatitis Pancreas 20 382–8 Occurrence Handle10824693 Occurrence Handle10.1097/00006676-200005000-00008 Occurrence Handle1:STN:280:DC%2BD3czovFWgtA%3D%3D
K Okazaki K Uchida M Ohana H Nakase S Uose M Inai et al. (2000) ArticleTitleAutoimmune-related pancreatitis is associated with autoantibodies and a Th1/Th2-type cellular immune response Gastroenterology 118 573–81 Occurrence Handle10702209 Occurrence Handle10.1016/S0016-5085(00)70264-2 Occurrence Handle1:CAS:528:DC%2BD3cXit1Smsb0%3D
N Egawa T Irie Y Tu T Kamisawa (2003) ArticleTitleA case of autoimmune pancreatitis with initially negative autoantibodies turning positive during the clinical course Dig Dis Sci 48 1705–8 Occurrence Handle14560987 Occurrence Handle10.1023/A:1025426508414
J Sahel M Barthet M Gasmi (2004) ArticleTitleAutoimmune pancreatitis: increasing evidence for a clinical entity with various patterns Eur J Gastroenterol Hepatol 16 1265–8 Occurrence Handle15618830 Occurrence Handle10.1097/00042737-200412000-00005
I Nishimori K Suda I Oi M Ogawa (2002) ArticleTitleResearch on the clinical state of autoimmune pancreatitis J Jpn Pancreas Soc 17 619–27
K Suda H Shiotsu T Nakamura J Akai T Nakamura (1994) ArticleTitlePancreatic fibrosis in patients with chronic alcohol abuse: correlation with alcoholic pancreatitis Am J Gastroenterol 89 2060–2 Occurrence Handle7942737 Occurrence Handle1:STN:280:DyaK2M%2FivFamsQ%3D%3D
K Suda M Takase Y Fukumura K Ogura A Ueda T Matsuda et al. (2005) ArticleTitleHistopathologic characteristics of autoimmune pancreatitis based on comparison with chronic pancreatitis Pancreas 30 355–8 Occurrence Handle15841047 Occurrence Handle10.1097/01.mpa.0000160283.41580.88
G Zamboni J Luttges P Capelli L Frulloni G Cavallini P Pederzoli et al. (2004) ArticleTitleHistopathological features of diagnostic and clinical relevance in autoimmune pancreatitis: a study on 53 resection specimens and 9 biopsy specimens Virchows Arch 445 552–63 Occurrence Handle15517359 Occurrence Handle10.1007/s00428-004-1140-z
SM Weber O Cubukcu-Dimopulo JA Palesty A Suriawinata D Klimstra MF Brennan et al. (2003) ArticleTitleLymphoplasmacytic sclerosing pancreatitis: inflammatory mimic of pancreatic carcinoma J Gastrointest Surg 7 129–37 Occurrence Handle12559194 Occurrence Handle10.1016/S1091-255X(02)00148-8
G Klöppel J Luttges M Lohr G Zamboni D Longnecker (2003) ArticleTitleAutoimmune pancreatitis: pathological, clinical and immunological features Pancreas 27 14–9 Occurrence Handle12826900 Occurrence Handle10.1097/00006676-200307000-00002
T Kamisawa (2004) ArticleTitleIgG4-positive plasma cells specifically infiltrate various organs in autoimmune pancreatitis Pancreas 29 167–8 Occurrence Handle15257111 Occurrence Handle10.1097/00006676-200408000-00014
T Kamisawa N Funata Y Hayashi Y Eishi M Koike K Tsuruta et al. (2003) ArticleTitleA new clinicopathological entity of IgG4-related autoimmune disease J Gastroenterol 38 982–4 Occurrence Handle14614606 Occurrence Handle10.1007/s00535-003-1175-y Occurrence Handle1:CAS:528:DC%2BD3sXovVKnu7Y%3D
T Kamisawa N Funata Y Hayashi (2004) ArticleTitleLymphoplasmacytic sclerosing pancreatitis is a pancreatic lesion of IgG4-related systemic disease Am J Surg Pathol 28 1114 Occurrence Handle15252325
MJ Wiersema P Vilmann M Giovannini KJ Chang LM Wiersema (1997) ArticleTitleEndosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment Gastroenterology 112 1087–95 Occurrence Handle9097990 Occurrence Handle1:STN:280:DyaK2s3lt1Chsw%3D%3D Occurrence Handle10.1016/S0016-5085(97)70164-1
MJ Levy MJ Wiersema ST Chari (2006) ArticleTitleChronic pancreatitis: focal pancreatitis or cancer? Is there a role for FNA/biopsy? Autoimmune pancreatitis Endoscopy 38 S30–5 Occurrence Handle16802220 Occurrence Handle10.1055/s-2006-946648
BS Dooreck P Katz JS Barkin (2004) ArticleTitleAutoimmune pancreatitis in the spectrum of autoimmune exocrinopathy associated with sialoadenitis and anosmia Pancreas 28 105–7 Occurrence Handle14707740 Occurrence Handle10.1097/00006676-200401000-00018
JC Penalva J Martinez E Pascual VM Palanca F Lluis F Peiro et al. (2003) ArticleTitleChronic pancreatitis associated with systemic lupus erythematosus in a young girl Pancreas 27 275–7 Occurrence Handle14508137 Occurrence Handle10.1097/00006676-200310000-00016 Occurrence Handle1:STN:280:DC%2BD3svkslKqug%3D%3D
E Kojima K Kimura Y Noda G Kobayashi K Itoh N Fujita (2003) ArticleTitleAutoimmune pancreatitis and multiple bile duct strictures treated effectively with steroid J Gastroenterol 38 603–7 Occurrence Handle12856677 Occurrence Handle10.1007/s00535-003-1178-8
T Kamisawa N Egawa H Nakajima (2003) ArticleTitleAutoimmune pancreatitis is a systemic autoimmune disease Am J Gastroenterol 98 2811–2 Occurrence Handle14687846 Occurrence Handle10.1111/j.1572-0241.2003.08758.x
K Uchida K Okazaki M Asada S Yazumi M Ohana T Chiba et al. (2003) ArticleTitleCase of chronic pancreatitis involving an autoimmune mechanism that extended to retroperitoneal fibrosis Pancreas 26 92–4 Occurrence Handle12499924 Occurrence Handle10.1097/00006676-200301000-00016
T Nishino F Toki H Oyama I Oi M Kobayashi K Takasaki et al. (2005) ArticleTitleBiliary tract involvement in autoimmune pancreatitis Pancreas 30 76–82 Occurrence Handle15632703
IR Mackay (1969) ArticleTitleAutoimmune disease Med J Aust 1 696–9 Occurrence Handle4890055 Occurrence Handle1:STN:280:DyaF1M7osFahsg%3D%3D
G Erkelens FP Vleggaar W Lesterhuis HR van Buuren SD Van der Werf (1999) ArticleTitleSclerosing pancreato-cholangitis responsive to steroid therapy Lancet 354 43–4 Occurrence Handle10406367 Occurrence Handle10.1016/S0140-6736(99)00603-0 Occurrence Handle1:STN:280:DyaK1MzjtlSjsg%3D%3D
S Kwon MH Kim EK Choi (2007) ArticleTitleThe diagnostic criteria for autoimmune chronic pancreatitis It is time to make a consensus 34 279–86
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kim, MH., Kwon, S. Diagnostic criteria for autoimmune chronic pancreatitis. J Gastroenterol 42 (Suppl 18), 42–49 (2007). https://doi.org/10.1007/s00535-007-2050-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00535-007-2050-z