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World J Clin Cases. Aug 26, 2020; 8(16): 3411-3430
Published online Aug 26, 2020. doi: 10.12998/wjcc.v8.i16.3411
Steroid-responsive pancreatitides
Mario Pelaez-Luna, Andrea Soriano-Rios, Ana C Lira-Treviño, Luis Uscanga-Domínguez
Mario Pelaez-Luna, Research Division School of Medicine, Universidad Nacional Autonoma de México, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition "Salvador Zubiran" Mexico City 14000, Mexico
Andrea Soriano-Rios, Ana C Lira-Treviño, Luis Uscanga-Domínguez, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition "Salvador Zubiran" Mexico City 14000, Mexico
Author contributions: Pelaez-Luna M was responsible for the concept, design, drafting, critical revision and final approval of the manuscript; Soriano-Rios A was responsible for data acquisition, interpretation, and drafting of the manuscript; Lira-Treviño AC was responsible for data acquisition, table design, interpretation and drafting of the manuscript; Uscanga-Dominguez L was responsible for drafting and making critical revisions to the content of the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mario Pelaez-Luna, MD, MSc, Associate Professor, Attending Doctor, Research Division School of Medicine, Universidad Nacional Autonoma de México, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition "Salvador Zubiran", Vasco de Quiroga 15, Belisario Domínguez Sección XVI, Mexico City 14000, Mexico. mariopl@prodigy.net.mx
Received: May 1, 2020
Peer-review started: May 1, 2020
First decision: June 18, 2020
Revised: July 3, 2020
Accepted: July 30, 2020
Article in press: July 30, 2020
Published online: August 26, 2020
Abstract

Autoimmune pancreatitis has received considerable attention, especially due to the marked effect of corticosteroid therapy on its clinical course. Knowledge, especially regarding type 1 autoimmune pancreatitis, has significantly increased over the last decades, and despite significant differences in pathophysiology and outcomes, both type 1 and 2 autoimmune pancreatitis are still considered different types of the same disease. Some have proposed a different nomenclature reflecting these differences. Although the term steroid-responsive pancreatitides may be interpreted as synonymous to type 1 and 2 autoimmune pancreatitis, these are not the only pancreatic conditions that show a response to steroid therapy. Acute pancreatitis caused by vasculitis and connective tissue diseases and acute pancreatitis secondary to checkpoint inhibitors or programmed cell death receptor antibody-mediated blockage cancer therapy may also benefit from steroid treatment. This review presents current concepts on these disorders, aiming to increase awareness, analyze similarities and differences, and propose a new nomenclature that reflects their specific particularities, clustering them under the term “steroid-responsive pancreatitides”.

Keywords: Autoimmune pancreatitis, Lymphoplasmacytic sclerosing pancreatitis, Idiopathic duct centric chronic pancreatitis, Vasculitis, Immune checkpoint inhibitors, Corticosteroids

Core tip: This review presents the rationale on the current evidence on pancreatic disorders that respond to steroid therapy. It focuses not only on autoimmune pancreatitis 1 and 2 but also on less recognized but relevant conditions, such as acute pancreatitis related to immune checkpoint inhibitors and vasculitis and connective tissue diseases that often need and respond to corticosteroid therapy. The aims are to increase awareness, analyze clinical and pathophysiological similarities and differences, recognize research opportunities, and propose a new nomenclature that reflects their specific particularities, clustering them under the term steroid-responsive pancreatitides.