Autoimmune pancreatitis classification: Difference between revisions

Jump to navigation Jump to search
Line 33: Line 33:


==Classification==
==Classification==
*Autoimmune pancreatitis can be
**Primary (when main pathology is in pancreas) or
**Secondary (when associated with other systemic autoimmune diseases such as IgG4-associated cholangitis, chronic sclerosing sialadenitis, tubulointerstitial nephritis, and ulcerative colitis
*Autoimmune pancreatitis may be classified into two types.
*Autoimmune pancreatitis may be classified into two types.
**Type 1 AIP
**Type 1 AIP

Revision as of 18:46, 18 December 2017

Autoimmune pancreatitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Autoimmune pancreatitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Guidelines for Management

Case Studies

Case #1

Autoimmune pancreatitis classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Autoimmune pancreatitis classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Autoimmune pancreatitis classification

CDC on Autoimmune pancreatitis classification

Autoimmune pancreatitis classification in the news

Blogs on Autoimmune pancreatitis classification

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Autoimmune pancreatitis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There is no established system for the classification of [disease name].

OR

[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].

OR

[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].

OR

Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

The staging of [malignancy name] is based on the [staging system].

OR

There is no established system for the staging of [malignancy name].

Classification

  • Autoimmune pancreatitis can be
    • Primary (when main pathology is in pancreas) or
    • Secondary (when associated with other systemic autoimmune diseases such as IgG4-associated cholangitis, chronic sclerosing sialadenitis, tubulointerstitial nephritis, and ulcerative colitis
  • Autoimmune pancreatitis may be classified into two types.
    • Type 1 AIP
    • Type 2 AIP or idiopathic duct-centric pancreatitis

Type 1 AIP:

  • Type 1 AIP meets the HISORt criteria.[1][2]
  • Type 1 AIP involves pancreas as one part of a systemic IgG4-positive disease.
  • Type 1 patients have high relapse rates when compared to type 2 patients.[3]
  • Type 1 patients are usually older on presentation.
  • Type 1 patients have higher prevalence of increased IgG4 levels.
  • Type 1 patients have greater extrapancreatic organ involvement compared to Type 2 AIP patients.
Criteria
(H) Histology suggestive of autoimmine pancreatitis
(I) Pancreatic imaging suggestive of autoimmine pancreatitis
(S) Serology (IgG4 ≥2 times the upper limit of normal)
(O) Other organ involvement
  • Biliary strictures
  • Parotid/lacrimal gland involvement
  • Mediastinal lymphadenopathy
  • Retroperitoneal fibrosis
(Rt) Response to steroid treatment

Type 2 AIP or Idiopathic duct-centric pancreatitis:

  • Type 2 consists of granulocytic lesions.
  • Type 2 does not involve IgG4-positive cells.
  • Type 2 has no systemic involvement.
  • Type 2 AIP is usually associated with inflammatory bowel disease.

References

  1. Chari ST, Takahashi N, Levy MJ, Smyrk TC, Clain JE, Pearson RK, Petersen BT, Topazian MA, Vege SS (2009). "A diagnostic strategy to distinguish autoimmune pancreatitis from pancreatic cancer". Clin. Gastroenterol. Hepatol. 7 (10): 1097–103. doi:10.1016/j.cgh.2009.04.020. PMID 19410017.
  2. Chari ST, Smyrk TC, Levy MJ, Topazian MD, Takahashi N, Zhang L, Clain JE, Pearson RK, Petersen BT, Vege SS, Farnell MB (2006). "Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience". Clin. Gastroenterol. Hepatol. 4 (8): 1010–6, quiz 934. doi:10.1016/j.cgh.2006.05.017. PMID 16843735.
  3. Sah RP, Chari ST, Pannala R, Sugumar A, Clain JE, Levy MJ, Pearson RK, Smyrk TC, Petersen BT, Topazian MD, Takahashi N, Farnell MB, Vege SS (2010). "Differences in clinical profile and relapse rate of type 1 versus type 2 autoimmune pancreatitis". Gastroenterology. 139 (1): 140–8, quiz e12–3. doi:10.1053/j.gastro.2010.03.054. PMID 20353791.

Template:WH Template:WS