Clinical profile of autoimmune pancreatitis and its histological subtypes

An international multicenter survey

Terumi Kamisawa, Suresh T. Chari, Samuel A. Giday, Myung Hwan Kim, Jae Bock Chung, Kyu Taek Lee, Jens Werner, Frank Bergmann, Markus M. Lerch, Julia Mayerle, Tilman Pickartz, Matthias Lohr, Alexander Schneider, Luca Frulloni, George J M Webster, D. Nageshwar Reddy, Wei Chih Liao, Hsiu Po Wang, Kazuichi Okazaki, Tooru Shimosegawa & 2 others Guenter Kloeppel, Vay Liang W Go

Research output: Contribution to journalArticle

Abstract

Objective: The objective of this study was to clarify the clinical and pathophysiological characteristics of autoimmune pancreatitis (AIP) and its subtypes (lymphoplasmacytic sclerosing pancreatitis [LPSP] and idiopathic duct-centric pancreatitis [IDCP]) seen around the world. Methods: An international multicenter survey of AIP was conducted in 15 institutes from 8 countries. We compared clinical and pathologic profiles of AIP (n = 731) and the clinical profiles of LPSP (n = 204) and IDCP (n = 64) patients. Results: Patients with LPSP were approximately 16 years older than IDCP patients. Obstructive jaundice was a more frequent presentation in LPSP versus IDCP (75% vs 47%, P <0.001), whereas abdominal pain (41% vs 68%, P <0.001) and acute pancreatitis (5% vs 34%, P <0.001) were more frequent in IDCP patients. Patients with LPSP were more likely to have diffuse swelling of the pancreas (40% vs 25%, P = 0.037) and elevated serum IgG4 levels (63% vs 23%, P <0.001) but less likely to be associated with ulcerative colitis (1% vs 16%, P <0.001). Clinical profiles of non-histologically confirmed AIP from Asia, the United States, and United Kingdom corresponded with that of LPSP, whereas those from Italy and Germany suggested a mixture of LPSP and IDCP. Conclusions: Autoimmune pancreatitis is seen all around the world, with regional differences in the pathologic and clinical features. Lymphoplasmacytic sclerosing pancreatitis and IDCP have distinct clinical profiles.

Original languageEnglish (US)
Pages (from-to)809-814
Number of pages6
JournalPancreas
Volume40
Issue number6
DOIs
StatePublished - Aug 2011

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Pancreatitis
Surveys and Questionnaires
Obstructive Jaundice

Keywords

  • chronic pancreatitis
  • idiopathic duct-centric pancreatitis
  • IgG4
  • lymphoplasmacytic sclerosing pancreatitis

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Kamisawa, T., Chari, S. T., Giday, S. A., Kim, M. H., Chung, J. B., Lee, K. T., ... Go, V. L. W. (2011). Clinical profile of autoimmune pancreatitis and its histological subtypes: An international multicenter survey. Pancreas, 40(6), 809-814. https://doi.org/10.1097/MPA.0b013e3182258a15

Clinical profile of autoimmune pancreatitis and its histological subtypes : An international multicenter survey. / Kamisawa, Terumi; Chari, Suresh T.; Giday, Samuel A.; Kim, Myung Hwan; Chung, Jae Bock; Lee, Kyu Taek; Werner, Jens; Bergmann, Frank; Lerch, Markus M.; Mayerle, Julia; Pickartz, Tilman; Lohr, Matthias; Schneider, Alexander; Frulloni, Luca; Webster, George J M; Reddy, D. Nageshwar; Liao, Wei Chih; Wang, Hsiu Po; Okazaki, Kazuichi; Shimosegawa, Tooru; Kloeppel, Guenter; Go, Vay Liang W.

In: Pancreas, Vol. 40, No. 6, 08.2011, p. 809-814.

Research output: Contribution to journalArticle

Kamisawa, T, Chari, ST, Giday, SA, Kim, MH, Chung, JB, Lee, KT, Werner, J, Bergmann, F, Lerch, MM, Mayerle, J, Pickartz, T, Lohr, M, Schneider, A, Frulloni, L, Webster, GJM, Reddy, DN, Liao, WC, Wang, HP, Okazaki, K, Shimosegawa, T, Kloeppel, G & Go, VLW 2011, 'Clinical profile of autoimmune pancreatitis and its histological subtypes: An international multicenter survey', Pancreas, vol. 40, no. 6, pp. 809-814. https://doi.org/10.1097/MPA.0b013e3182258a15
Kamisawa, Terumi ; Chari, Suresh T. ; Giday, Samuel A. ; Kim, Myung Hwan ; Chung, Jae Bock ; Lee, Kyu Taek ; Werner, Jens ; Bergmann, Frank ; Lerch, Markus M. ; Mayerle, Julia ; Pickartz, Tilman ; Lohr, Matthias ; Schneider, Alexander ; Frulloni, Luca ; Webster, George J M ; Reddy, D. Nageshwar ; Liao, Wei Chih ; Wang, Hsiu Po ; Okazaki, Kazuichi ; Shimosegawa, Tooru ; Kloeppel, Guenter ; Go, Vay Liang W. / Clinical profile of autoimmune pancreatitis and its histological subtypes : An international multicenter survey. In: Pancreas. 2011 ; Vol. 40, No. 6. pp. 809-814.
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AU - Kim, Myung Hwan

AU - Chung, Jae Bock

AU - Lee, Kyu Taek

AU - Werner, Jens

AU - Bergmann, Frank

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AU - Mayerle, Julia

AU - Pickartz, Tilman

AU - Lohr, Matthias

AU - Schneider, Alexander

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AU - Liao, Wei Chih

AU - Wang, Hsiu Po

AU - Okazaki, Kazuichi

AU - Shimosegawa, Tooru

AU - Kloeppel, Guenter

AU - Go, Vay Liang W

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N2 - Objective: The objective of this study was to clarify the clinical and pathophysiological characteristics of autoimmune pancreatitis (AIP) and its subtypes (lymphoplasmacytic sclerosing pancreatitis [LPSP] and idiopathic duct-centric pancreatitis [IDCP]) seen around the world. Methods: An international multicenter survey of AIP was conducted in 15 institutes from 8 countries. We compared clinical and pathologic profiles of AIP (n = 731) and the clinical profiles of LPSP (n = 204) and IDCP (n = 64) patients. Results: Patients with LPSP were approximately 16 years older than IDCP patients. Obstructive jaundice was a more frequent presentation in LPSP versus IDCP (75% vs 47%, P <0.001), whereas abdominal pain (41% vs 68%, P <0.001) and acute pancreatitis (5% vs 34%, P <0.001) were more frequent in IDCP patients. Patients with LPSP were more likely to have diffuse swelling of the pancreas (40% vs 25%, P = 0.037) and elevated serum IgG4 levels (63% vs 23%, P <0.001) but less likely to be associated with ulcerative colitis (1% vs 16%, P <0.001). Clinical profiles of non-histologically confirmed AIP from Asia, the United States, and United Kingdom corresponded with that of LPSP, whereas those from Italy and Germany suggested a mixture of LPSP and IDCP. Conclusions: Autoimmune pancreatitis is seen all around the world, with regional differences in the pathologic and clinical features. Lymphoplasmacytic sclerosing pancreatitis and IDCP have distinct clinical profiles.

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