Clinical diagnosis and treatment of autoimmune pancreatitis / 中华普通外科杂志

ABSTRACT

Objective:To investigate the clinical manifestations ,diagnosis and treatment of autoimmune pancreatitis (AIP).Methods:The clinical data of 17 AIP patients admitted at the First Affiliated Hospital of Soochow University from Apr 2021 to Jan 2023 were retrospectively analyzed.Results:Among the 17 AIP patients, 12 were male (70.6%). Ten complained abdominal pain (58.8%), and 8 had jaundice (47.1%). Fifteen patients had elevated IgG4 levels more than twice the normal value (88.2%), and 14 patients had elevated liver enzymes (82.3%). The imaging manifestations of 17 patients were all diffuse or limited enlargement of the pancreas. All patients had diffuse or limited enlargement of the pancreas, some were accompanied by a dilatation of the pancreatic duct or bile duct. Fourteen patients were diagnosed by combining the clinical manifestations, imaging examination, laboratory examination, and puncture pathology, and in 3 cases the diagnosis was confirmed by postoperative pathology. Fourteen patients showed significant improvement in clinical symptoms and imaging manifestations after hormone therapy, 2 patients stopped hormone medication on their own after the improvement of the imaging, and 1 suffered recurrence,which was responsible to hormone readministration.Conclusions:AIP, as a rare and easily misdiagnosed immune disease, involves the pancreas leading to an inflammatory response and often encroaches peri-pancreatic areas such as the bile ducts, causing biliary stenosis and jaundice. Most patients respond well to glucocorticoid therapy and surgery was usually not indicated in those with definite AIP diagnosis.