Autoimmune pancreatitis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Pathophysiology
Pathogenesis
Genetics
- [Disease name] is transmitted in [mode of genetic transmission] pattern.
- Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
- The development of [disease name] is the result of multiple genetic mutations.
Associated Conditions
- Autoimmune pancreatitis may be associated with systemic autoimmune conditions such as:[1][2][3][4][5][6][7][8][9]
- IgG4-associated cholangitis
- Chronic sclerosing sialadenitis (Küttner's tumor)
- Mikulicz's disease (IgG4-related plasmacytic exocrinopathy)
- Mediastinal fibrosis, adenopathy
- Chronic periaortitis
- Idiopathic retroperitoneal fibrosis
- Tubulointerstitial nephritis
- IgG4-associated pseudolymphoma
- Ulcerative colitis
- Hypergammaglobulinemia
Gross Pathology
- On gross pathology, findings suggestive of autoimmune pancreatitis may include
- Diffuse pancreatic gland enlargement
Microscopic Pathology
- Microscopic findings suggestive of autoimmune pancreatitis may include:[10]
Type 1 AIP:
- A lymphoplasmacytic sclerosing pancreatitis
- >10 IgG4-positive cells with at least two of the following
- Periductal lymphoplasmacytic infiltrate
- Obliterative phlebitis
- Acinar fibrosis
Type 2 AIP or Idiopathic duct-centric pancreatitis (IDCP):
- Pancreatic duct: Granulocytic epithelial lesion
- Pancreatic parenchyma: Minimal IgG4-positive cells
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.