title: ERCP features in 27 patients with autoimmune pancreatitis.
abstract: BACKGROUND
  Autoimmune pancreatitis has been proposed as a new clinical entity. However, the ERCP features of this entity have not been well described.
  
  
  METHODS
  Clinical and radiographic features in 27 patients with a diagnosis of autoimmune pancreatitis were evaluated.
  
  
  RESULTS
  All 27 patients were at first suspected to have pancreatic cancer. The patients were predominantly elderly men and presented with jaundice or mild symptoms and pancreatic enlargement, but no attack of acute pancreatitis. A cholestatic biochemical profile and serum IgG elevation were usually present. A diffusely or segmentally irregular and narrow main pancreatic duct and a positive response to corticosteroid therapy were characteristic. During observation without treatment, serial pancreatography in 2 patients demonstrated progression of diffuse, irregular narrowing of the main pancreatic duct over periods, respectively, of 2 and 6 months. Both the irregular narrowing of the main pancreatic duct and distal bile duct strictures improved in various degrees in response to corticosteroid therapy.
  
  
  CONCLUSIONS
  Segmental or diffuse irregular narrowing of the main pancreatic duct are ERCP features of autoimmune pancreatitis.
authors.affiliation: Second Department of Internal Medicine and Department of Central Clinical Laboratory, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hamano
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Hayama
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ota
authors.forename: Kendo
authors.initials: K
authors.lastname: Kiyosawa
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D005938:Glucocorticoids; D011239:Prednisolone