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Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition) ›› 2023, Vol. 10 ›› Issue (01): 46-51. doi: 10.3877/cma.j.issn.2095-7157.2023.01.013

• Original Article • Previous Articles     Next Articles

Analysis of clinical features of autoimmune pancreatitis

Shenxin Chen1, Yaqi Zhai1, Baoguo Bu1, Dexin Chen1, Lang Wu1, Kaixuan Fang1, Wenjing Liu1, Mingyang Li1,(), Enqiang Linghu1,()   

  1. 1. Department of Gastroenterology, The First Medical Center, Chinese PLA General Hospital, 100853 Beijing, China
  • Received:2022-12-29 Online:2023-02-15 Published:2023-04-21
  • Contact: Mingyang Li, Enqiang Linghu

Abstract:

Objective

To explore the clinical characteristics of Chinese AIP patients with the aim to raise the clinical awareness of diagnosis and treatment.

Methods

All clinical data about 103 patients with AIP in the PLA General Hospital from December 2011 to December 2020 were analyzed.

Results

The clinical manifestations were mainly obstructive jaundice and mild abdominal pain or discomfort. 64 cases (62.1%) showed diffuse enlargement of the pancreas on imaging, including 34 cases (33.0%) showed characteristic "sausage-like" swelling, 42 cases (40.8%) had pancreatic duct dilatation, and 58 cases (78.4%) showed characteristic delayed enhancement on MRI-enhanced scans. The pancreatic ducts were dilated in 42 cases (40.8%). Extra-pancreatic lesions with multiple lymphadenopathy and bile duct involvement were common. The serum IgG4 positivity rate was 96.1%. The pancreatic puncture pathology compliance rate was 24.4%.The overall effectiveness of glucocorticoid and combined glucocorticoid regimens was 98.8%. 11 cases underwent surgical resection or dissection and anastomosis. The recurrence rate after treatment was 48.5%, and their main recurrent manifestations were jaundice and pancreatic enlargement.

Conclusion

Type 1 AIP is the main subtype of AIP in our hospital without special clinical symptoms, however, it has unique features of extra-pancreatic lesions, imaging, serology and histopathology. Glucocorticoid therapy is very sensitive, but prone to relapse. Differentiation of focal AIP from pancreatic cancer remains challenging, and comprehensive analysis can effectively increase the correct diagnosis rate of AIP.

Key words: Autoimmune pancreatitis, IgG4-related Pancreatitis, Epidemiology, Pancreatic cancer, Differential diagnosis

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