首页|Differences between diffuse and focal autoimmune pancreatitis
Differences between diffuse and focal autoimmune pancreatitis
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NETL
NSTL
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维普
AIM:To investigate differences in clinical features between diffuse-and focal-type autoimmune pancreatitis (AIP).METHODS:Based on radiological findings by computed tomography and/or magnetic resonance imaging,we divided 67 AIP patients into diffuse type (D type)and focal type (F type).We further divided F type into head type (H type) and body and/or tail type (B/T type)according to the location of enlargement.Finally,we classified the 67 AIP patients into three groups:D type,H type and B/F type.We compared the three types of AIP in terms of clinical,laboratory,radiological,functional and histological findings and clinical course.RESULTS:There were 34 patients with D-type,19 with H-type and 14 with B/T-type AIP.Although obstructive jaundice was frequently detected in D-type patients (88％) and H-type patients (68％),no B/T-type patients showed jaundice as an initial symptom (P ＜ 0.001).There were no differences in frequency of abdominal pain,but acute pancreatitis was associated more frequently in B/T-type patients (36％) than in D-type patients (3％) (P =0.017).Serum immunoglobulin G (IgG)4 levels were significantly higher in D-type patients (median 309 mg/dL) than in B/T-type patients (133.5 mg/dL) (P =0.042).Serum amylase levels in B/T-type patients (median:114 IU/L) were significantly greater than in H-type patients (72 IU/L) (P =0.049).Lymphoplasmacytic sclerosing pancreatitis (LPSP) was histologically confirmed in 6 D-type,7 H-type and 4 B/T-type patients; idiopathic duct-centric pancreatitis was observed in no patients.Marked fibrosis and abundant infiltration of CD20-positive B lymphocytes with few IgG4-positive plasma cells were detected in 2 B/T-type patients.Steroid therapy was effective in all 50 patients (31 D type,13 H type and 6 B/T type).Although AIP relapsed during tapering or after stopping steroids in 3 D-type and 3 H-type patients,no patients relapsed in B/T type.During follow-up,radiological features of 6 B/T-type patients were not changed and 1 B/T-type patient improved naturally.CONCLUSION:Clinical features of H-type AIP were similar to those of D-type,but B/T-type differed from D and H types.B/T-type may involve diseases other than LPSP.
Autoimmune pancreatitisImmunoglobulin G 4Lymphoplasmacytic sclerosing pancreatitis
NETL
NSTL
万方数据
维普
