Skip to main content
Log in

Diagnosis of autoimmune pancreatitis using its five cardinal features: introducing the Mayo Clinic's HISORt criteria

  • Diagnostic Criteria
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Autoimmune pancreatitis (AIP) is a recently defined form of chronic pancreatitis. While numerous case reports and small case series of AIP have been reported from Japan, there have been relatively few from the West. Based on a retrospective review of our experience with resected AIP and a review of the literature, we have identified five cardinal features of AIP in histology, imaging, serology, other organ involvement, and response to steroid therapy, which are summarized in the mnemonic HISORt. A combination of the HISORt criteria can be used to definitively diagnose a wide spectrum of manifestations of AIP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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

    Article  PubMed  Google Scholar 

  2. G Kloppel 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

    Article  PubMed  Google Scholar 

  3. K Notohara LJ Burgart D Yadav S Chari TC Smyrk (2003) ArticleTitleIdiopathic chronic pancreatitis with periductal lymphoplasmacytic infiltration: clinicopathologic features of 35 cases Am J Surg Pathol 27 1119–27 Occurrence Handle12883244 Occurrence Handle10.1097/00000478-200308000-00009

    Article  PubMed  Google Scholar 

  4. N Ectors B Maillet R Aerts K Geboes A Donner F Borchard et al. (1997) ArticleTitleNon-alcoholic duct-destructive chronic pancreatitis Gut 41 263–8 Occurrence Handle9301509 Occurrence Handle1:STN:280:DyaK2svkslSmug%3D%3D Occurrence Handle10.1136/gut.41.2.263

    Article  PubMed  CAS  Google Scholar 

  5. SC Abraham RE Wilentz CJ Yeo TA Sohn JL Cameron JK Boitnott et al. (2003) ArticleTitlePancreaticoduodenectomy (Whipple resections) in patients without malignancy: are they all “chronic pancreatitis Am J Surg Pathol 27 110–20 Occurrence Handle12502933 Occurrence Handle10.1097/00000478-200301000-00012

    Article  PubMed  Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. 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

    Article  PubMed  CAS  Google Scholar 

  9. T Kamisawa N Funata Y Hayashi K Tsuruta A Okamoto K Amemiya et al. (2003) ArticleTitleClose relationship between autoimmune pancreatitis and multifocal fibrosclerosis Gut 52 683–7 Occurrence Handle12692053 Occurrence Handle10.1136/gut.52.5.683 Occurrence Handle1:STN:280:DC%2BD3s7ntlGqug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. 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

    PubMed  Google Scholar 

  11. L Zhang K Notohara MJ Levy ST Chari TC Smyrk (2007) ArticleTitleIgG4-positive plasma cell infiltration in the diagnosis of autoimmune pancreatitis Modern Pathology 20 23–8 Occurrence Handle16980948 Occurrence Handle10.1038/modpathol.3800689 Occurrence Handle1:CAS:528:DC%2BD28XhtlaktrnO

    Article  PubMed  CAS  Google Scholar 

  12. 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

    CAS  Google Scholar 

  13. 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

    Article  PubMed  CAS  Google Scholar 

  14. 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

    PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. T Wakabayashi Y Kawaura Y Satomura H Watanabe Y Motoo T Okai et al. (2003) ArticleTitleClinical and imaging features of autoimmune pancreatitis with focal pancreatic swelling or mass formation: comparison with so-called tumor-forming pancreatitis and pancreatic carcinoma Am J Gastroenterol 98 2679–87 Occurrence Handle14687817 Occurrence Handle10.1111/j.1572-0241.2003.08727.x

    Article  PubMed  Google Scholar 

  18. M Takayama H Hamano Y Ochi H Saegusa K Komatsu T Muraki et al. (2004) ArticleTitleRecurrent attacks of autoimmune pancreatitis result in pancreatic stone formation Am J Gastroenterol 99 932–7 Occurrence Handle15128363 Occurrence Handle10.1111/j.1572-0241.2004.04162.x

    Article  PubMed  Google Scholar 

  19. T Nishimura T Masaoka H Suzuki K Aiura H Nagata H Ishii (2004) ArticleTitleAutoimmune pancreatitis with pseudocysts J Gastroenterol 39 1005–10 Occurrence Handle15549456 Occurrence Handle10.1007/s00535-004-1436-4

    Article  PubMed  Google Scholar 

  20. T Ichikawa K Nakao K Hamasaki K Ohkubo K Toriyama K Eguchi (2005) ArticleTitleAn autopsy case of acute pancreatitis with a high serum IgG4 complicated by amyloidosis and rheumatoid arthritis World J Gastroenterol 11 2032–4 Occurrence Handle15801001

    PubMed  Google Scholar 

  21. 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

    Article  PubMed  CAS  Google Scholar 

  22. J Kino-Ohsaki I Nishimori M Morita K Okazaki Y Yamamoto S Onishi et al. (1996) ArticleTitleSerum antibodies to carbonic anhydrase I and II in patients with idiopathic chronic pancreatitis and Sjogren's syndrome Gastroenterology 110 1579–86 Occurrence Handle8613065 Occurrence Handle10.1053/gast.1996.v110.pm8613065 Occurrence Handle1:CAS:528:DyaK28XjtV2htbg%3D

    Article  PubMed  CAS  Google Scholar 

  23. 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

    Article  PubMed  CAS  Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

  26. Y Zen K Harada M Sasaki Y Sato K Tsuneyama J Haratake et al. (2004) ArticleTitleIgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis? Am J Surg Pathol 28 1193–203 Occurrence Handle15316319 Occurrence Handle10.1097/01.pas.0000136449.37936.6c

    Article  PubMed  Google Scholar 

  27. 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

    PubMed  Google Scholar 

  28. T Kamisawa N Egawa S Inokuma K Tsuruta A Okamoto N Kamata et al. (2003) ArticleTitlePancreatic endocrine and exocrine function and salivary gland function in autoimmune pancreatitis before and after steroid therapy Pancreas 27 235–8 Occurrence Handle14508128 Occurrence Handle10.1097/00006676-200310000-00007 Occurrence Handle1:CAS:528:DC%2BD2cXks1yisQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  29. T Kamisawa M Yoshiike N Egawa H Nakajima K Tsuruta A Okamoto (2005) ArticleTitleTreating patients with autoimmune pancreatitis: results from a long-term follow-up study Pancreatology 5 234–8 Occurrence Handle15855821 Occurrence Handle10.1159/000085277

    Article  PubMed  Google Scholar 

  30. M Yamamoto H Takahashi S Sugai K Imai (2005) ArticleTitleClinical and pathological characteristics of Mikulicz's disease (IgG4-related plasmacytic exocrinopathy) Autoimmun Rev 4 195–200 Occurrence Handle15893711 Occurrence Handle10.1016/j.autrev.2004.10.005

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chari, S. Diagnosis of autoimmune pancreatitis using its five cardinal features: introducing the Mayo Clinic's HISORt criteria. J Gastroenterol 42 (Suppl 18), 39–41 (2007). https://doi.org/10.1007/s00535-007-2046-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-007-2046-8

Key words

Navigation