Prevalence, Diagnosis, and Profile of Autoimmune Pancreatitis Presenting with Features of Acute or Chronic Pancreatitis

Raghuwansh P. Sah, Rahul Pannala, Suresh T Chari, Aravind Sugumar, Jonathan E. Clain, Michael J. Levy, Randall K. Pearson, Thomas Christopher Smyrk, Bret Thomas Petersen, Mark Topazian, Naoki Takahashi, Santhi Swaroop Vege

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background & Aims: Little is known about how many patients with features of acute pancreatitis (AP) or chronic pancreatitis (CP) have autoimmune pancreatitis (AIP); most information comes from case reports. We explored the clinical profiles and relationship between these diseases. Methods: We evaluated 178 patients presenting to our Pancreas Clinic between January 2005 and June 2006 for evaluation of the etiology of their suspected pancreatitis; AIP was diagnosed when patients met HISORt (Histology, Imaging features, Serology, Other organ involvement and Response to steroid treatment) criteria. In a separate cohort of patients with AIP from our database, we identified patients who presented with features of AP (≥2 of abdominal pain, increased pancreatic enzymes, pancreatic inflammation determined by imaging analyses) or CP (≥1 of pancreatic calcification, irregular main pancreatic duct dilation, or marked atrophy) and determined their clinical profile. Results: Only 7/178 (3.9%) patients evaluated for etiology of suspected pancreatitis had AIP. Among 63 AIP patients in our database, 22 (34.9%) had features of AP (n = 15) or CP (n = 7) at presentation (average age 53.4 ± 19.0 years, all males). Patients with AIP and pancreatitis were characterized by presence of obstructive jaundice (59.1%), increased levels of liver enzymes (81.8%), increased levels of serum immunoglobulin G4 (80.9%), and other organ involvement (69.1%). All 19 patients presenting with pancreatitis who were treated with steroids responded to treatment. Conclusions: While AIP is an uncommon etiology for acute or chronic pancreatitis, >33% of AIP have features of acute or chronic pancreatitis at presentation.

Original languageEnglish (US)
Pages (from-to)91-96
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume8
Issue number1
DOIs
StatePublished - Jan 2010

Fingerprint

Chronic Pancreatitis
Pancreatitis
Steroids
Databases
Obstructive Jaundice
Pancreatic Ducts
Serology
Enzymes
Abdominal Pain
Atrophy
Immunoglobulins
Dilatation
Pancreas
Histology

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Prevalence, Diagnosis, and Profile of Autoimmune Pancreatitis Presenting with Features of Acute or Chronic Pancreatitis. / Sah, Raghuwansh P.; Pannala, Rahul; Chari, Suresh T; Sugumar, Aravind; Clain, Jonathan E.; Levy, Michael J.; Pearson, Randall K.; Smyrk, Thomas Christopher; Petersen, Bret Thomas; Topazian, Mark; Takahashi, Naoki; Vege, Santhi Swaroop.

In: Clinical Gastroenterology and Hepatology, Vol. 8, No. 1, 01.2010, p. 91-96.

Research output: Contribution to journalArticle

Sah, Raghuwansh P. ; Pannala, Rahul ; Chari, Suresh T ; Sugumar, Aravind ; Clain, Jonathan E. ; Levy, Michael J. ; Pearson, Randall K. ; Smyrk, Thomas Christopher ; Petersen, Bret Thomas ; Topazian, Mark ; Takahashi, Naoki ; Vege, Santhi Swaroop. / Prevalence, Diagnosis, and Profile of Autoimmune Pancreatitis Presenting with Features of Acute or Chronic Pancreatitis. In: Clinical Gastroenterology and Hepatology. 2010 ; Vol. 8, No. 1. pp. 91-96.
@article{02c8824385694832937ce5dcbb5f0a20,
title = "Prevalence, Diagnosis, and Profile of Autoimmune Pancreatitis Presenting with Features of Acute or Chronic Pancreatitis",
abstract = "Background & Aims: Little is known about how many patients with features of acute pancreatitis (AP) or chronic pancreatitis (CP) have autoimmune pancreatitis (AIP); most information comes from case reports. We explored the clinical profiles and relationship between these diseases. Methods: We evaluated 178 patients presenting to our Pancreas Clinic between January 2005 and June 2006 for evaluation of the etiology of their suspected pancreatitis; AIP was diagnosed when patients met HISORt (Histology, Imaging features, Serology, Other organ involvement and Response to steroid treatment) criteria. In a separate cohort of patients with AIP from our database, we identified patients who presented with features of AP (≥2 of abdominal pain, increased pancreatic enzymes, pancreatic inflammation determined by imaging analyses) or CP (≥1 of pancreatic calcification, irregular main pancreatic duct dilation, or marked atrophy) and determined their clinical profile. Results: Only 7/178 (3.9{\%}) patients evaluated for etiology of suspected pancreatitis had AIP. Among 63 AIP patients in our database, 22 (34.9{\%}) had features of AP (n = 15) or CP (n = 7) at presentation (average age 53.4 ± 19.0 years, all males). Patients with AIP and pancreatitis were characterized by presence of obstructive jaundice (59.1{\%}), increased levels of liver enzymes (81.8{\%}), increased levels of serum immunoglobulin G4 (80.9{\%}), and other organ involvement (69.1{\%}). All 19 patients presenting with pancreatitis who were treated with steroids responded to treatment. Conclusions: While AIP is an uncommon etiology for acute or chronic pancreatitis, >33{\%} of AIP have features of acute or chronic pancreatitis at presentation.",
author = "Sah, {Raghuwansh P.} and Rahul Pannala and Chari, {Suresh T} and Aravind Sugumar and Clain, {Jonathan E.} and Levy, {Michael J.} and Pearson, {Randall K.} and Smyrk, {Thomas Christopher} and Petersen, {Bret Thomas} and Mark Topazian and Naoki Takahashi and Vege, {Santhi Swaroop}",
year = "2010",
month = "1",
doi = "10.1016/j.cgh.2009.09.024",
language = "English (US)",
volume = "8",
pages = "91--96",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Prevalence, Diagnosis, and Profile of Autoimmune Pancreatitis Presenting with Features of Acute or Chronic Pancreatitis

AU - Sah, Raghuwansh P.

AU - Pannala, Rahul

AU - Chari, Suresh T

AU - Sugumar, Aravind

AU - Clain, Jonathan E.

AU - Levy, Michael J.

AU - Pearson, Randall K.

AU - Smyrk, Thomas Christopher

AU - Petersen, Bret Thomas

AU - Topazian, Mark

AU - Takahashi, Naoki

AU - Vege, Santhi Swaroop

PY - 2010/1

Y1 - 2010/1

N2 - Background & Aims: Little is known about how many patients with features of acute pancreatitis (AP) or chronic pancreatitis (CP) have autoimmune pancreatitis (AIP); most information comes from case reports. We explored the clinical profiles and relationship between these diseases. Methods: We evaluated 178 patients presenting to our Pancreas Clinic between January 2005 and June 2006 for evaluation of the etiology of their suspected pancreatitis; AIP was diagnosed when patients met HISORt (Histology, Imaging features, Serology, Other organ involvement and Response to steroid treatment) criteria. In a separate cohort of patients with AIP from our database, we identified patients who presented with features of AP (≥2 of abdominal pain, increased pancreatic enzymes, pancreatic inflammation determined by imaging analyses) or CP (≥1 of pancreatic calcification, irregular main pancreatic duct dilation, or marked atrophy) and determined their clinical profile. Results: Only 7/178 (3.9%) patients evaluated for etiology of suspected pancreatitis had AIP. Among 63 AIP patients in our database, 22 (34.9%) had features of AP (n = 15) or CP (n = 7) at presentation (average age 53.4 ± 19.0 years, all males). Patients with AIP and pancreatitis were characterized by presence of obstructive jaundice (59.1%), increased levels of liver enzymes (81.8%), increased levels of serum immunoglobulin G4 (80.9%), and other organ involvement (69.1%). All 19 patients presenting with pancreatitis who were treated with steroids responded to treatment. Conclusions: While AIP is an uncommon etiology for acute or chronic pancreatitis, >33% of AIP have features of acute or chronic pancreatitis at presentation.

AB - Background & Aims: Little is known about how many patients with features of acute pancreatitis (AP) or chronic pancreatitis (CP) have autoimmune pancreatitis (AIP); most information comes from case reports. We explored the clinical profiles and relationship between these diseases. Methods: We evaluated 178 patients presenting to our Pancreas Clinic between January 2005 and June 2006 for evaluation of the etiology of their suspected pancreatitis; AIP was diagnosed when patients met HISORt (Histology, Imaging features, Serology, Other organ involvement and Response to steroid treatment) criteria. In a separate cohort of patients with AIP from our database, we identified patients who presented with features of AP (≥2 of abdominal pain, increased pancreatic enzymes, pancreatic inflammation determined by imaging analyses) or CP (≥1 of pancreatic calcification, irregular main pancreatic duct dilation, or marked atrophy) and determined their clinical profile. Results: Only 7/178 (3.9%) patients evaluated for etiology of suspected pancreatitis had AIP. Among 63 AIP patients in our database, 22 (34.9%) had features of AP (n = 15) or CP (n = 7) at presentation (average age 53.4 ± 19.0 years, all males). Patients with AIP and pancreatitis were characterized by presence of obstructive jaundice (59.1%), increased levels of liver enzymes (81.8%), increased levels of serum immunoglobulin G4 (80.9%), and other organ involvement (69.1%). All 19 patients presenting with pancreatitis who were treated with steroids responded to treatment. Conclusions: While AIP is an uncommon etiology for acute or chronic pancreatitis, >33% of AIP have features of acute or chronic pancreatitis at presentation.

UR - http://www.scopus.com/inward/record.url?scp=72049110768&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=72049110768&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2009.09.024

DO - 10.1016/j.cgh.2009.09.024

M3 - Article

VL - 8

SP - 91

EP - 96

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 1

ER -