Endoscopic ultrasound features of autoimmune pancreatitis: The typical findings and chronic pancreatitis changes

Table 1 Comparison of patients’ demographics and clinical manifestations before corticosteroid treatment

	All (n = 285)	Diffuse type (n = 214)	Focal type (n = 71)	P value
Sex	230 (80.7)	179 (83.6)	51 (71.8)	0.03
Age	62 (54, 68)	62 (55, 68)	59 (53, 68)	0.12
Follow-up time (mo)	26 (12, 51)	28 (13, 51)	21 (9, 51)	0.13
Symptoms
Abdominal pain	73 (26.0)	51 (23.8)	22 (31.0)	0.23
Jaundice	106 (37.2)	81 (37.8)	25 (35.2)	0.69
Number of involved organs1	1 (1, 2)	1 (1, 2)	1 (1, 2)	0.47
Laboratory tests
ALT (U/L) (9-50)	47 (18, 133)	64 (18, 184)	30 (15, 83)	0.01
TBil (μmol/L) (5.1-22.2)	20.6 (12.2, 55.6)	21.4 (12.9, 68.7)	14.5 (11.6, 45.2)	0.08
IgG (mg/dL) (700-1700)	1590 (1140, 2070)	1630 (1130, 2140)	1510 (1130, 1760)	0.37
IgG4 (mg/dL) (8-140)	558.0 (280.5, 1270.0)	605.5 (253.5, 1457.5)	458.0 (301.0, 1050.0)	0.26
CA 19-9 (U/L) (0-34.0)	20.3 (7.9, 61.0)	23.4 (10.5, 74.1)	12.6 (6.7, 36.5)	0.01

¹Involved organs included salivary gland, lacrimal gland, lung, kidney, liver, bile duct, retroperitoneal fibrosis and prostate gland.

Results presented as median (interquartile range) or n (%). ALT: Alanine transaminase; CA: Carbohydrate antigen; TBil: Total bilirubin; Ig: Immunoglobulin.

Table 2 Comparison of endoscopic ultrasound features between the diffuse and focal types of autoimmune pancreatitis patients

EUS findings	All (n = 285)	Diffuse type (n = 214)	Focal type (n = 71)	P value
Typical findings
DHA	213 (74.7)	197 (92.1)	16 (22.5)	< 0.001
FHA	59 (20.7)	0 (0)	59 (83.1)	< 0.001
Bile duct changes
Bile duct wall thickening	195 (68.4)	158 (73.4)	37 (52.1)	0.001
Intrapancreatic bile duct stenosis	165 (57.9)	131 (61.2)	34 (47.9)	0.05
Extrahepatic bile duct dilation	122 (42.8)	97 (45.3)	25 (35.2)	0.14
Peripancreatic changes
Peripancreatic lymphadenopathy	89 (31.2)	72 (33.6)	17 (23.9)	0.13
Peripancreatic hypoechoic margin	81 (28.4)	76 (35.5)	5 (7.0)	< 0.001
Lobular outer margin	40 (14.0)	34 (15.9)	6 (8.5)	0.12
Peripancreatic vessel involvement	21 (7.4)	16 (7.5)	5 (7.0)	0.90
Chronic pancreatitis changes
Parenchymal changes
HF	271 (95.1)	202 (94.4)	69 (97.2)	0.531
HS	174 (61.1)	131 (61.2)	43(60.6)	0.92
Cystic lesion	18 (6.3)	14 (6.5)	4 (5.6)	1.001
Parenchymal calcification	3 (1.1)	2 (0.9)	1 (1.4)	1.001
Lobularity with honeycombing	26 (9.1)	19 (8.9)	7 (9.9)	0.80
Lobularity without honeycombing	48 (16.8)	36 (16.8)	12 (16.9)	0.99
Main pancreatic duct changes
MPD calculi	1 (0.4)	0 (0)	1 (1.4)	0.561
MPD dilation	48 (16.8)	30 (14.0)	18 (25.3)	0.03
Diffuse stenosis/irregularity	29 (10.2)	20 (9.3)	9 (12.7)	0.42
Focal stenosis	11 (3.9)	6 (2.8)	5 (7.0)	0.151
Hyperechoic duct margin	119 (41.8)	91 (42.5)	28 (39.4)	0.65

¹Fisher’s exact test.

Results presented as n (%). DHA: Diffuse hypoechoic area; EUS: Endoscopic ultrasound; FHA: Focal hypoechoic area; HF: Hyperechoic foci; HS: Hyperechoic strand; MPD: Main pancreatic duct.

Table 3 The logistic regression for predictors of diffuse autoimmune pancreatitis

Effect	Odds ratio (95%CI)	P value
DHA	11.23 (3.07, 41.03)	< 0.001
Bile duct wall thickening	4.44 (2.49, 7.93)	< 0.001
Peripancreatic hypoechoic margin	4.34 (1.93, 9.80)	< 0.001

CI: Confidence index; DHA: Diffuse hypoechoic area.

Table 4 The Rosemont Criteria for description of chronic pancreatitis change in newly diagnosed autoimmune pancreatitis patients

Rosemont criteria	Diffuse type (n = 14)	Focal type (n = 71)	P value
Consistent with CP	2 (0.9)	1 (1.4)	0.45
Suggestive of CP	26 (12.1)	11 (15.5)
Indeterminate of CP	174 (81.3)	58 (81.7)
Normal	12 (5.6)	1 (1.4)

Results presented as n (%). CP: Chronic pancreatitis.