Clinical Profile of Autoimmune Pancreatitis and Its Histological Subtypes An International Multicenter Survey
Clinical Profile of Autoimmune Pancreatitis and Its Histological Subtypes An International Multicenter Survey
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DOI：
10.1097/mpa.0b013e3182258a15
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发表时间：
2011-08-01
期刊：
影响因子：
2.9
通讯作者：
Go, Vay Liang W.
中科院分区：
文献类型：
--
作者：
Kamisawa, Terumi;Chari, Suresh T.;Go, Vay Liang W.
目的：探讨自身免疫性胰腺炎(AIP)及其亚型(淋巴浆细胞性硬化性胰腺炎(LPSP)和特发性导管中心性胰腺炎(IDCP))的临床和病理生理特点。我们比较了731例急性胰腺炎、204例慢性胰腺炎和慢性胰腺炎患者的临床和病理特点。梗阻性黄疸在腹痛(41%比68%，P<；0.001)和急性胰腺炎(5%比34%，P<；0.001)中更常见。LPSP患者更有可能出现胰腺弥漫性肿胀(40%比25%，P=0.037)和血清Ig G4水平升高(63%比23%，P<；0.001)，但较少发生溃疡性结肠炎(1%比16%，P<；0.001)。来自亚洲、美国和英国的未经组织学证实的AIP与LPSP的临床特征一致，而来自意大利和德国的AIP则建议为LPSP和IDCP.混合型。结论：自身免疫性胰腺炎在世界范围内广泛存在，其病理和临床特征存在地区差异。淋巴浆硬化性胰腺炎和IDCP具有不同的临床特点。
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.