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Autoimmune-related pancreatitis

Current Treatment Options in Gastroenterology volume 4, pages 369–375 (2001)Cite this article

Opinion statement

The treatment of patients with autoimmune pancreatitis poses a challenge to the clinician. Prednisone, in an initial dosage of 30 to 40 mg/d, is used in patients with moderate abdominal and back pain, obstructive jaundice, or sclerosing cholangitis. Antacid or anticholinergic agents may be used to minimize stimulation of pancreatic exocrine function. Patients with quiescent disease may not need pharmacologic medication. In patients with complications such as obstructive jaundice and infection, biliary drainage and administration of antibiotics are recommended prior to steroid therapy. Steroid therapy occasionally ameliorates diabetes mellitus associated with autoimmune pancreatitis.

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References and Recommended Reading

  1. Sarles H, Sarles JC, Camatte R, et al.: Observation on 205 confirmed cases of acute pancreatitis, recurring pancreatitis, and chronic pancreatitis. Gut 1965, 6:545–559.

    PubMed  CAS  Google Scholar 

  2. Montefusco PP, Geiss AC, Bronzo RL, et al.: Sclerosing cholangitis, chronic pancreatitis, and SjS:A syndrome complex. Am J Surg 1984, 147:822–826.

    PubMed  Article  CAS  Google Scholar 

  3. Epstein O, Chapman RWG, Lake-Bakaar G, et al.: The pancreas in primary biliary cirrhosis and primary sclerosing cholangitis. Gastroenterology 1982, 83:1177–1182.

    PubMed  CAS  Google Scholar 

  4. Strand V, Talal N: Advances in the diagnosis and concept of Sjörgen’s syndrome (autoimmune exocrinopathy). Bull Rheum Dis 1979, 30:1046–1052.

    PubMed  Google Scholar 

  5. Toki F, Kozu T, Oi I: An unusual type of chronic pancreatitis showing diffuse irregular narrowing of the entire main pancreatic duct on ERC-A of four cases. Endoscopy 1992: 24:640.

    Google Scholar 

  6. Lankisch PG, Koop H, Seelig R, et al.: Antinuclear and pancreatic acinar cell antibodies in pancreatic disease. Digestion 1981, 21:65–68.

    PubMed  CAS  Article  Google Scholar 

  7. Yoshida K, Toki F, Takeuchi T, et al.: Chronic pancreatitis caused by autoimmune abnormality. Proposal of concept of autoimmune pancreatitis. Dig Dis Sci 1995, 40:1561–1568.

    PubMed  Article  CAS  Google Scholar 

  8. Ohana M, Okazaki K, Hajiro K, et al.: Multiple pancreatic masses associated with autoimmunity. Am J Gastroenteeol. 1996, 93:2607–2609.

    Google Scholar 

  9. Horiuchi A, Kaneki T, Yamamura M, et al.: Autoimmune chronic pancreatitis simulating pancreatic lymphoma. Am J Gastroenterol 1996, 91:2607–2609.

    PubMed  CAS  Google Scholar 

  10. Horiuchi A, Kawa S, Akamatsu T, et al.: Characteristic pancreatic duct appearance in autoimmune chronic pancreatitis: a case report and review of the Japanese literature. Am J Gastroenterol 1998, 93:99–102.

    Article  Google Scholar 

  11. Tanaka S, Kobayashi T, Nakanishi K, et al.: Corticosteroid-responsive diabetes mellitus associated with autoimmune pancreatitis. Lancet 2000, 356:910–911. The effects of improvement in diabetes mellitus-associated autoimmune pancreatitis by steroid therapy is discussed.

    PubMed  Article  CAS  Google Scholar 

  12. UchidaK, Okazaki K, Konishi Y, et al.: Clinical analysis of autoimmune-related pancreatitis. Am J Gastorenterol 2000, 95:2788–2794. Data from patients with autoimmune-related pancreatitis are analyzed and the effects of steroid therapy are mentioned.

    Article  CAS  Google Scholar 

  13. Coll J, Navarro S, Tomas R, et al.: Exocrine pancreatic function in Sjogren syndrome. Arch Intern Med 1989, 149:848–852.

    PubMed  Article  CAS  Google Scholar 

  14. Sheikh SH, Shaw-Stiffel TA: The gastrointestinal manifestations of Sjogren’s syndrome. Am J Gastroenterol 1995, 90:9–14.

    PubMed  CAS  Google Scholar 

  15. Waldram R, Kopelman H, Tsantoulas D, et al.: Chronic pancreatitis, sclerosing cholangitis, and sicca complex in two siblings. Lancet 1975, 7906:550–552.

    Article  Google Scholar 

  16. Okazaki K, Uchida K, Ohana M, et al.: Autoimmunerelated pancreatitis is associated with autoantibodies and Th1/Th2-type cellular immune response. Gastroenterology. 2000, 118:1–10.

    Article  Google Scholar 

  17. Etemad B, Whitcomb DC: Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology 2001, 120:682–707.

    PubMed  Article  CAS  Google Scholar 

  18. OkazakiK, Uchida K, Chiba T: Recent concept of autoimmune-related pancreatitis. J Gastroenterol 2001, 36:293–302. Recent concepts of autoimmune-related pancreatitis are reviewed.

    PubMed  Article  CAS  Google Scholar 

  19. Irie H, Honda H, Baba S, et al.: Autoimmune pancreatitis: CT and MR characteristics. AJR Am J Roentgenol 1998, 170:1323–1327.

    PubMed  CAS  Google Scholar 

  20. Furukawa N, Muranaka T, Yasumori K, et al.: Autoimmune pancreatitis: radiologic findings in three histologically proven cases. J Comput Assist Tomogr 1998, 22:880–883.

    PubMed  Article  CAS  Google Scholar 

  21. Nakamoto Y, Sakahara H, Higashi T, et al.: Autoimmune pancreatitis with F-18 fluoro-2-deoxy-D-glucose PET findings. J Clin Nucl Med 1999, 24:778–780.

    Article  Google Scholar 

  22. Hamono H, Kawa S, Horiuchi A, et al.: High serum IgG4 concentrations in patients with sclerosing cholangitis. N Engl J Med 2001, 344:732–738.

    Article  Google Scholar 

  23. 2000 Drug Topics Red Book. Montvale, NJ: Medical Economics Co.; 2000.

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Authors and Affiliations

  1. Department of Gastroenterology and Endoscopic Medicine, Kyoto University Hospital, Shogoin-Kawaracho, Sakyo, 606-8507, Kyoto, Japan

    Kazuichi Okazaki MD, PhD

Authors
  1. Kazuichi Okazaki MD, PhD
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Okazaki, K. Autoimmune-related pancreatitis. Curr Treat Options Gastro 4, 369–375 (2001). https://doi.org/10.1007/s11938-001-0002-x

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  • DOI: https://doi.org/10.1007/s11938-001-0002-x

Keywords

  • Pancreatitis
  • Common Bile Duct
  • Chronic Pancreatitis
  • Primary Biliary Cirrhosis
  • Steroid Therapy