Autoimmune pancreatitis diagnostic study of choice

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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

Diagnostic Study of Choice

Template statements

Gold standard/Study of choice:

  • [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
  • The following result of [gold standard test] is confirmatory of [disease name]:
    • Result 1
    • Result 2
  • The [name of investigation] should be performed when:
    • The patient presented with symptoms/signs 1. 2, 3.
    • A positive [test] is detected in the patient.
  • [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
  • The diagnostic study of choice for [disease name] is [name of investigation].
  • There is no single diagnostic study of choice for the diagnosis of [disease name].
  • There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
  • [Disease name] is mainly diagnosed based on clinical presentation.
  • Investigations:
    • Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
    • Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
    • Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.

The comparison table for diagnostic studies of choice for [disease name]

Sensitivity Specificity
Test 1 ...%
Test 2 ...%

✔= The best test based on the feature

Diagnostic results

The following result of [investigation name] is confirmatory of [disease name]:

  • Result 1
  • Result 2
Sequence of Diagnostic Studies

The [name of investigation] should be performed when:

  • The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
  • A positive [test] is detected in the patient, to confirm the diagnosis.

Diagnostic Criteria

Autoimmune pancreatitis is diagnosed by revised HISORt criteria, proposed by Mayo clinic and may include one or more of the following:[1][2]

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

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.