Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2023; 11(1): 30-46
Published online Jan 6, 2023. doi: 10.12998/wjcc.v11.i1.30
Challenges for clinicians treating autoimmune pancreatitis: Current perspectives
Seong-Hun Kim, Yun Chae Lee, Hyung Ku Chon
Seong-Hun Kim, Yun Chae Lee, Division of Gastroenterology, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54907, South Korea
Hyung Ku Chon, Department of Internal Medicine, Institution of Wonkwang Medical Science, Wonkwang University School of Medicine and Hospital, Iksan 54538, South Korea
Author contributions: Lee YC and Chon HK wrote the paper and performed the collected the data; Kim SH performed critical review, collected the data and supervision.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyung Ku Chon, MD, PhD, Associate Professor, Department of Internal Medicine, Wonkwang University School of Medicine and Hospital, 895 Muwang-Ro, Iksan 54538, Jeonbuk, South Korea. gipb2592@wku.ac.kr
Received: September 12, 2022
Peer-review started: September 12, 2022
First decision: October 19, 2022
Revised: October 31, 2022
Accepted: December 19, 2022
Article in press: December 19, 2022
Published online: January 6, 2023
Abstract

Autoimmune pancreatitis (AIP) is a rare disease clinically characterized by obstructive jaundice, unintentional weight loss, acute pancreatitis, focal pancreatic mass, and diabetes. AIP is classified into two subtypes - type 1 and type 2 - according to pathological findings, clinical features, and serology test results, but some cases may be defined as type not otherwise in the absence of pathological findings and inflammatory bowel disease. To address the differences in diagnostic criteria by country, standard diagnostic criteria for AIP were proposed in 2011 by an international consensus of expert opinions. Differential diagnosis of AIP from pancreatic ductal adenocarcinoma is important but remains challenging for clinicians. Fortunately, all subtypes of AIP show dramatic response to steroid treatment. This review discusses the current perspectives on the diagnosis and management of AIP in clinical practice.

Keywords: Autoimmune pancreatitis, Pancreatic cancer, International consensus diagnostic criteria, Steroid

Core Tip: Autoimmune pancreatitis (AIP) is a rare disease characterized by obstructive jaundice, acute pancreatitis, and focal pancreatic mass. Lymphoplasmacytic sclerosing pancreatitis (type 1) and idiopathic duct centric pancreatitis (type 2) are histopathologically distinct. Typical imaging features and pathologic findings are crucial in the diagnosis of AIP to distinguish it from pancreatic ductal adenocarcinoma. Responses to steroid treatment are dramatic, but relapses are common. A careful approach to maintenance treatment is thus required.