Autoimmune pancreatitis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
Overview
Patients with autoimmune pancreatitis may do not have a positive history of alcohol abuse. Common symptoms of autoimmune pancreatitis include mild abdominal pain, abdominal mass/pancreatic mass, painless jaundice, weight loss, and diabetes mellitus. Less common symptoms may include symptoms related to other autoimmune diseases such as Sjögren's syndrome, primary sclerosing cholangitis (PSC), inflammatory bowel disease (IBD), and retroperitoneal fibrosis. Autoimmune pancreatitis may have extra-pancreatic involvement such as bile duct, salivary gland, retroperitoneum, kidneys, and orbit depending upon the various stages of autoimmune pancreatitis.
History and Symptoms
History
Patients with autoimmune pancreatitis may do not have a positive history of:
- Alcohol abuse
- Other predisposing factors of chronic pancreatitis
Common Symptoms
Common symptoms of autoimmune pancreatitis include:
- Mild abdominal pain[1][2]
- Abdominal mass/pancreatic mass[3]
- Painless jaundice[4][5][6][7]
- Dark urine
- Nausea, vomiting
- Loss of appetite
- Pale stools
- Weight loss
- Diabetes mellitus[8][9]
Less Common Symptoms
Less common symptoms of autoimmune pancreatitis include:
Extra-pancreatic involvement depending upon the various stages of autoimmune pancreatitis:
Autoimmune pancreatitis can present in a variety of ways depending upon the stage of involvement.[14][4][3][15][16][17][18][19][5]
| Organ/System | Disease/manifestation |
|---|---|
| Bile ducts | IgG4-associated cholangitis |
| Salivary gland | Chronic sclerosing sialadenitis (Küttner's tumor) |
| Mikulicz's disease (IgG4-related plasmacytic exocrinopathy) | |
| Chest | Patchy ground glass, nodular, and consolidative lung opacities |
| Mediastinal fibrosis, adenopathy | |
| Retroperitoneum |
|
| Kidneys | Tubulointerstitial nephritis |
| Orbits | IgG4-associated pseudolymphoma |
| Inflammatory bowel disease | Ulcerative colitis |
References
- ↑ Frulloni L, Scattolini C, Falconi M, Zamboni G, Capelli P, Manfredi R, Graziani R, D'Onofrio M, Katsotourchi AM, Amodio A, Benini L, Vantini I (2009). "Autoimmune pancreatitis: differences between the focal and diffuse forms in 87 patients". Am. J. Gastroenterol. 104 (9): 2288–94. doi:10.1038/ajg.2009.327. PMID 19568232.
- ↑ Varadarajulu S, Cotton PB (2003). "Autoimmune pancreatitis: is it relevant in the west?". Gastroenterology. 125 (5): 1557. PMID 14628814.
- ↑ 3.0 3.1 3.2 Raina A, Yadav D, Krasinskas AM, McGrath KM, Khalid A, Sanders M, Whitcomb DC, Slivka A (2009). "Evaluation and management of autoimmune pancreatitis: experience at a large US center". Am. J. Gastroenterol. 104 (9): 2295–306. doi:10.1038/ajg.2009.325. PMID 19532132.
- ↑ 4.0 4.1 Ghazale A, Chari ST, Zhang L, Smyrk TC, Takahashi N, Levy MJ, Topazian MD, Clain JE, Pearson RK, Petersen BT, Vege SS, Lindor K, Farnell MB (2008). "Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy". Gastroenterology. 134 (3): 706–15. doi:10.1053/j.gastro.2007.12.009. PMID 18222442.
- ↑ 5.0 5.1 Church NI, Pereira SP, Deheragoda MG, Sandanayake N, Amin Z, Lees WR, Gillams A, Rodriguez-Justo M, Novelli M, Seward EW, Hatfield AR, Webster GJ (2007). "Autoimmune pancreatitis: clinical and radiological features and objective response to steroid therapy in a UK series". Am. J. Gastroenterol. 102 (11): 2417–25. doi:10.1111/j.1572-0241.2007.01531.x. PMID 17894845.
- ↑ Sahani DV, Kalva SP, Farrell J, Maher MM, Saini S, Mueller PR, Lauwers GY, Fernandez CD, Warshaw AL, Simeone JF (2004). "Autoimmune pancreatitis: imaging features". Radiology. 233 (2): 345–52. doi:10.1148/radiol.2332031436. PMID 15459324.
- ↑ Sandanayake NS, Church NI, Chapman MH, Johnson GJ, Dhar DK, Amin Z, Deheragoda MG, Novelli M, Winstanley A, Rodriguez-Justo M, Hatfield AR, Pereira SP, Webster GJ (2009). "Presentation and management of post-treatment relapse in autoimmune pancreatitis/immunoglobulin G4-associated cholangitis". Clin. Gastroenterol. Hepatol. 7 (10): 1089–96. doi:10.1016/j.cgh.2009.03.021. PMID 19345283.
- ↑ Horiuchi A, Kawa S, Hamano H, Hayama M, Ota H, Kiyosawa K (2002). "ERCP features in 27 patients with autoimmune pancreatitis". Gastrointest. Endosc. 55 (4): 494–9. PMID 11923760.
- ↑ Pearson RK, Longnecker DS, Chari ST, Smyrk TC, Okazaki K, Frulloni L, Cavallini G (2003). "Controversies in clinical pancreatology: autoimmune pancreatitis: does it exist?". Pancreas. 27 (1): 1–13. PMID 12826899.
- ↑ Kamisawa T, Egawa N, Inokuma S, Tsuruta K, Okamoto A, Kamata N, Nakamura T, Matsukawa M (2003). "Pancreatic endocrine and exocrine function and salivary gland function in autoimmune pancreatitis before and after steroid therapy". Pancreas. 27 (3): 235–8. PMID 14508128.
- ↑ Montefusco PP, Geiss AC, Bronzo RL, Randall S, Kahn E, McKinley MJ (1984). "Sclerosing cholangitis, chronic pancreatitis, and Sjogren's syndrome: a syndrome complex". Am. J. Surg. 147 (6): 822–6. PMID 6731702.
- ↑ Epstein O, Chapman RW, Lake-Bakaar G, Foo AY, Rosalki SB, Sherlock S (1982). "The pancreas in primary biliary cirrhosis and primary sclerosing cholangitis". Gastroenterology. 83 (6): 1177–82. PMID 7129026.
- ↑ Uchida K, Okazaki K, Asada M, Yazumi S, Ohana M, Chiba T, Inoue T (2003). "Case of chronic pancreatitis involving an autoimmune mechanism that extended to retroperitoneal fibrosis". Pancreas. 26 (1): 92–4. PMID 12499924.
- ↑ Hirano K, Shiratori Y, Komatsu Y, Yamamoto N, Sasahira N, Toda N, Isayama H, Tada M, Tsujino T, Nakata R, Kawase T, Katamoto T, Kawabe T, Omata M (2003). "Involvement of the biliary system in autoimmune pancreatitis: a follow-up study". Clin. Gastroenterol. Hepatol. 1 (6): 453–64. PMID 15017645.
- ↑ Tabata M, Kitayama J, Kanemoto H, Fukasawa T, Goto H, Taniwaka K (2003). "Autoimmune pancreatitis presenting as a mass in the head of the pancreas: a diagnosis to differentiate from cancer". Am Surg. 69 (5): 363–6. PMID 12769204.
- ↑ Erkelens GW, Vleggaar FP, Lesterhuis W, van Buuren HR, van der Werf SD (1999). "Sclerosing pancreato-cholangitis responsive to steroid therapy". Lancet. 354 (9172): 43–4. PMID 10406367.
- ↑ Kojima E, Kimura K, Noda Y, Kobayashi G, Itoh K, Fujita N (2003). "Autoimmune pancreatitis and multiple bile duct strictures treated effectively with steroid". J. Gastroenterol. 38 (6): 603–7. PMID 12856677.
- ↑ Horiuchi A, Kaneko T, Yamamura N, Nagata A, Nakamura T, Akamatsu T, Mukawa K, Kawa S, Kiyosawa K (1996). "Autoimmune chronic pancreatitis simulating pancreatic lymphoma". Am. J. Gastroenterol. 91 (12): 2607–9. PMID 8946997.
- ↑ Hamano H, Kawa S, Uehara T, Ochi Y, Takayama M, Komatsu K, Muraki T, Umino J, Kiyosawa K, Miyagawa S (2005). "Immunoglobulin G4-related lymphoplasmacytic sclerosing cholangitis that mimics infiltrating hilar cholangiocarcinoma: part of a spectrum of autoimmune pancreatitis?". Gastrointest. Endosc. 62 (1): 152–7. PMID 15990840.