Authors: Kazuichi Okazaki Kazushige Uchida Mitsunobu Matsushita Makoto Takaoka
Publish Date: 2007/05/22
Volume: 42, Issue: 18, Pages: 32-38
Abstract
When diagnosing autoimmune pancreatitis AIP it is most important to differentiate it from neoplastic lesions such as pancreatic or biliary cancers The revised diagnostic criteria are based on the minimum consensus of AIP in order to avoid misdiagnosing pancreas or biliary cancer as far as possible but not for screening AIP Therefore it is recommended that facile therapeutic diagnosis by steroidal administration should be avoided These criteria contain three approaches pancreatic imaging laboratory data and histopathology i Pancreatic image examinations show the narrowing of the main pancreatic duct and enlargement of the pancreas which are characteristic of the disease ii Laboratory data show the presence of autoantibodies or elevated levels of serum gammaglobulin IgG or IgG4 iii Histopathologial examinations of the pancreas show fibrosis and pronounced infiltration of cells mainly lymphocytes and plasmacytes which is called lymphoplasmacytic sclerosing cholangitis LPSP For a diagnosis of AIP criterion i must be present together with criterion ii and/or iii However it is necessary to exclude malignant diseases such as pancreatic or biliary cancers
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