November 12, 2014
Notes: Wu, Li
Research Support, Non-U.S. Gov’t
J Ethnopharmacol. 2013 Dec 12;150(3):960-6. doi: 10.1016/j.jep.2013.09.051. Epub 2013 Oct 24.
Author Address: College of Pharmacy, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Nanjing 210023, PR China; Engineering Center of State Ministry of Education for Standardization of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; National First-Class Key Discipline for Science of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, PR China.
Reference Type: Journal Article
Record Number: 4978Author: Wu, L., Li, W., Huang, X. and Wang, Z.
Title: Clinical features and comprehensive diagnosis of autoimmune pancreatitis in China
Short Title: Clinical features and comprehensive diagnosis of autoimmune pancreatitis in China
Alternate Journal: Digestion
ISSN: 1421-9867 (Electronic)
Accession Number: 24008239
Abstract: AIM: To search for the key factors of autoimmune pancreatitis (AIP) in China and to improve the early identification of AIP in order to avoid misdiagnosing it as pancreatic carcinoma. METHODS: Clinical, imaging, laboratory, and pathological data about AIP were collected and analyzed from 1996 to 2011 in The Chinese People’s Liberation Army General Hospital. RESULTS: A total of 33 patients (male 29, female 4) aged 35-76 years (52.3 +/- 9.3 years) meeting the International Consensus Diagnostic Criteria for type 1 (n = 32) or type 2 (n = 1) AIP were included. With improved understanding of AIP, the misdiagnosis rate and unnecessary laparotomy rate was decreased from 95.7% (22/23) and 91.3% (21/23) before 2006, to 20.0% (2/10) (p = 0.001) and 0.0% (p = 0.001) respectively after 2006. The major symptoms were jaundice in (24/33, 72.7%) and abdominal pain (12/33, 36.4%). Half of the patients had other accompanied autoimmune disorders. Laboratory tests showed an elevated level of serum IgG in 9 out of 11 patients (81.8%) and an increased eosinophil count in 16 out of 33 patients (48.5%). The serum IgG4 levels were twice the upper limit of the normal value. CT scan showed a low-contrast margin characterized by a capsule-like rim in 24 of 32 patients (75.0%). Pathologic examinations showed fibrosis and infiltration of massive lymphocytes and plasma cells in the pancreas. Prednisone was given to the patients and proved to be quite effective for all of them (12/12, 100%). CONCLUSION: Type 1 AIP shows a sex predilection compared with type 2 AIP in China. In order to diagnose AIP exactly, a comprehensive strategy, especially including imaging and pathological examination, should be used. With growing awareness, fewer AIP patients with this diagnosis would be misdiagnosed and incorrectly treated.