Abdominal pain, diarrhea, jaundice?

Abdominal pain, diarrhea, abnormal liver enzymes and jaundice.

What kind of disease is this? How to identify and diagnose autoimmune pancreatitis?

01What is autoimmune pancreatitis?

Since the medical community first proposed the concept of autoimmune pancreatitis (AIP) in 1995, the disease has been widely reported around the world.

However, since the mass-type AIP is similar to pancreatic cancer, and the prognosis of the two is quite different, it is very important to identify and diagnose autoimmune pancreatitis

Autoimmune pancreatitis is currently divided into two categories, type 1 AIP (also known as lymphocytic plasma cell sclerosing pancreatitis/IgG4-related pancreatitis) and type 2 AIP (also known as idiopathic ductal central pancreatitis)

02What are the clinical manifestations of autoimmune pancreatitis?

The two types of AIP are mainly clinically different.

During disease progression, inflammation damages the pancreatic endocrine function, leading to the occurrence of diabetes; severe cases may be accompanied by pancreatic exocrine insufficiency, manifesting as abdominal pain, diarrhea, and severe malnutrition

At the same time, type 1 AIP is an IgG4-related systemic disease, and extra-pancreatic organ involvement is seen in half of the patients, which is also one of the important clinical manifestations

03What tests should be done for autoimmune pancreatitis?

In terms of laboratory tests, IgG4, as a serum marker related to type 1 AIP, plays an important role in the diagnosis of AIP, and IgG4 has shown high accuracy in identifying AIP, chronic pancreatitis and pancreatic cancer;

Since it is difficult to distinguish pancreatic mass from pancreatic cancer, CA199 in tumor markers can be used to differentiate the two diseases to a certain extent.

Imaging examinations are often screened by CT and MRI.

04How is autoimmune pancreatitis treated?

Hormone is the drug of choice for treatment.

Serum markers and imaging examinations were reviewed 2 weeks later, and steroid doses were gradually reduced in the follow-up assessment.

In addition, other immunosuppressive agents such as azathioprine are also used for treatment, but they all need to be combined with hormones to induce remission and then be single-drug maintenance therapy

Most patients with this disease do not need surgical treatment, but there are still a small number of patients with obvious fibrosis around the lesion, and drugs cannot play a role.