Autoimmune pancreatitis.
BACKGROUND
Approximately 2 per cent of pancreatic masses resected for suspected malignancy are found instead to be a form of chronic pancreatitis defined by a characteristic lymphoplasmacytic infiltrate. This condition is now commonly classified as 'autoimmune pancreatitis'.


METHODS
A literature review of autoimmune pancreatitis was performed using Medline and PubMed. The reference lists of identified articles were searched for further relevant publications.


RESULTS
Patients are predominantly 55-65 years old and present with obstructive jaundice, abdominal pain and weight loss. Imaging may show a mass of malignant appearance or pancreatobiliary tree strictures precipitating surgical exploration. Raised serum levels of IgG4 and specific autoantibodies, when combined with particular radiological features and a biopsy negative for malignancy, enable a preoperative diagnosis and successful treatment with steroids.


CONCLUSIONS
Autoimmune pancreatitis is not uncommon and steroid treatment can effect a dramatic improvement. Care is needed to ensure that pancreatic cancer is not misdiagnosed.
Toomey
D P
DP
Professorial Surgical Unit, University of Dublin, Trinity College, Adelaide and Meath Hospitals-National Children's Hospital, Tallaght, Dublin 24, Ireland.
Swan
N
N
Torreggiani
W
W
Conlon
K C
KC
D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D049448:Cholangiopancreatography, Magnetic Resonance; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D013256:Steroids / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D007074:Immunoglobulin G; D013256:Steroids