title: Autoimmune pancreatitis: a report from India.
abstract: BACKGROUND
  Autoimmune pancreatitis is characterized by immune-mediated inflammation, prominent lymphocytic infiltration and fibrosis of pancreas. It accounts for 4.6-6% of chronic pancreatitis but only a few cases from India have been reported.
  
  
  OBJECTIVE
  Evaluation of cases of autoimmune pancreatitis diagnosed between July 2006 and June 2009.
  
  
  METHODS
  Retrospective analysis of the clinical records of all patients diagnosed as autoimmune pancreatitis between July 2006 and June 2009.
  
  
  METHODS
  Tertiary care centre, northern India.
  
  
  METHODS
  Clinical records of all patients with autoimmune pancreatitis were analyzed with respect to their initial diagnosis and treatment, imaging, cytology, serology, presence of other organ involvement and response to treatment.
  
  
  RESULTS
  The 5 cases of autoimmune pancreatitis included 4 men and one woman ranging in age from 48 to 60 years. The interval between initial consultation and diagnosis ranged from 3 months to 7 years. Symptoms included obstructive jaundice (5/5), abdominal pain (3/5) and weight loss (3/5). In 3 cases a presumptive diagnosis of a pancreatic mass with a biliary stricture was made and, in one patient, the diagnosis of primary sclerosing cholangitis was considered. These four patients had received a biliary stent and it was only on follow-up and review of the repeat CT scan that a diagnosis of autoimmune pancreatitis was suggested. In one patient, a diagnosis of autoimmune pancreatitis was considered in the first instance. Radiologically, all 5 patients showed a bulky pancreas with loss of lobulations.
  
  
  CONCLUSIONS
  In this report from India, we highlight the need for a high index of suspicion in diagnosing autoimmune pancreatitis because it responds dramatically to steroids.
authors.affiliation: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Mohd T
authors.initials: MT
authors.lastname: Noor
authors.forename: Anupam
authors.initials: A
authors.lastname: Lal
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kochhar
authors.forename: Manphool
authors.initials: M
authors.lastname: Singhal
authors.forename: Gurbakshish S
authors.initials: GS
authors.lastname: Sidhu
authors.forename: Radhika
authors.initials: R
authors.lastname: Srinivasan
authors.forename: Amit
authors.initials: A
authors.lastname: Rawat
authors.forename: Usha
authors.initials: U
authors.lastname: Dutta
authors.forename: Radha K
authors.initials: RK
authors.lastname: Dhiman
authors.forename: Yogesh K
authors.initials: YK
authors.lastname: Chawla
authors.forename: Kartar
authors.initials: K
authors.lastname: Singh
mesh_terms: D001327:Autoimmune Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D044963:Biopsy, Fine-Needle; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007194:India; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007074:Immunoglobulin G; D011239:Prednisolone