title: Asian diagnostic criteria for autoimmune pancreatitis: consensus of the Japan-Korea Symposium on Autoimmune Pancreatitis.
abstract: In 2002, the Japan Pancreas Society (JPS) was the first in the world to propose diagnostic criteria for autoimmune pancreatitis (AIP). Since the concept of AIP has changed with the accumulation of AIP cases, the Research Committee of Intractable Pancreatic Diseases (RCIPD) provided by the Ministry of Health, Labour and Welfare of Japan and the JPS issued revised clinical diagnostic criteria of AIP in 2006. The Asan Medical Center of Korea also proposed diagnostic criteria for AIP in 2006. However, there are subtle but clinically challenging differences between the Japanese and Korean criteria. This inconsistency makes it difficult to compare data in studies from different centers and elucidate the characteristics of AIP. To reach a consensus on AIP, the RCIPD and the Korean Society of Pancreatobiliary Diseases established the following Asian criteria for the diagnosis of AIP: I-1. Imaging studies of pancreatic parenchyma show a diffuse/segmental/focally enlarged gland, occasionally with a mass and/or a hypoattenuation rim. I-2. Imaging studies of pancreaticobiliary ducts show diffuse/segmental/focal pancreatic ductal narrowing, often with stenosis of the bile duct. (Both I-1 and I-2 are required for diagnosis). II. Elevated level of serum IgG or IgG4, and detection of autoantibodies. III. Common lymphoplasmacytic infiltration and fibrosis, with abundant IgG4-positive cell infiltration. AIP should be diagnosed when criterion I and one of the other two criteria are satisfied, or when histology shows the presence of lymphoplasmacytic sclerosing pancreatitis in the resected pancreas. A diagnostic trial of steroid therapy can be applied carefully by expert pancreatologists only in patients fulfilling criterion I alone with negative diagnostic work-up results for pancreatobiliary cancer.
authors.affiliation: Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health, Japan, School of Medicine, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuki
authors.forename: Jae Bock
authors.initials: JB
authors.lastname: Chung
authors.forename: Kazuichi
authors.initials: K
authors.lastname: Okazaki
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawa
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
authors.forename: Kyutaek
authors.initials: K
authors.lastname: Lee
authors.forename: Tetsuhide
authors.initials: T
authors.lastname: Ito
authors.forename: Isao
authors.initials: I
authors.lastname: Nishimori
authors.forename: Kenji
authors.initials: K
authors.lastname: Notohara
authors.forename: Satoru
authors.initials: S
authors.lastname: Naruse
authors.forename: Shigeru B H
authors.initials: SB
authors.lastname: Ko
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D010195:Pancreatitis / Q000175:diagnosis* / Q000188:drug therapy