Medicina, Vol. 49 No. 4, 2013.
Pregledni rad
Autoimmune pancreatitis
Irena Krznarić Zrnić
; Klinika za internu medicinu, Zavod za gastroenterologiju, KBC Rijeka, Rijeka
Davor Štimac
; Klinika za internu medicinu, Zavod za gastroenterologiju, KBC Rijeka, Rijeka
Sandra Milić
; Klinika za internu medicinu, Zavod za gastroenterologiju, KBC Rijeka, Rijeka
Sažetak
Autoimmune pancreatitis (AIP) is recognised as a distinct clinical entity, identified
as a chronic inflammatory process of the pancreas in which the autoimmune mechanism is
involved. Histologycally and clinically we can differ two subsets: type 1 – lymphoplasmacytic
sclerosing pancreatitis with other organ involvement and IgG4 positive cells infiltration and
type 2- duct centric fibrosis, characterised by granulocyte epithelial lesions without systemic
involvement, mostly in younger people. The major symptom at onset is obstructive jaundice,
while severe abdominal pain is rare. About half patients with AIP have shown endocrine
and exocrine disfunctions. The positive rate of antinuclear antibody is about 40 %, but
the most sensitive and specific serologycal marker today is still IgG4. In the diagnosis of AIP
two diagnostic criterions are used: the HISORt criteria (Mayo Clinic) and Asian diagnostic
criteria. In differential diagnosis it is most importanat to exclude pancreatic cancer by endosonographically
guided biopsy. Although high steroid responsiveness has a significant impact
on the diagnosis of AIP, since patients with pancreatic cancer and AIP share many clinical
features, there’s still no standardised steroid regimen. Even though the frequency of this
disease seems to be quite low, by increasing knowledge on this subject in the future it will
be possible to diagnose ever – increasing number of patients having acute recurrence of
pain from autoimmune pancreatitis.
Ključne riječi
autoimmune pancreatitis; diagnostic criteria; IgG4; treatment
Hrčak ID:
112516
URI
Datum izdavanja:
2.12.2013.
Posjeta: 6.959 *