title: Differentiation of autoimmune pancreatitis with pancreatic carcinoma remains a challenge to physicians.
abstract: OBJECTIVE
  The aim of this study was to summarize the clinical features of autoimmune pancreatitis (AIP) and review the advances in the differential diagnosis with pancreatic carcinoma, thus help to make a correct diagnosis and avoid unnecessary surgery in clinical practice.
  
  
  METHODS
  Five patients diagnosed as AIP in accordance with the HISORt criteria in Zhongshan Hospital, Fudan University from 2008 to 2010 were enrolled in the study. Clinical features were analyzed and related literature was reviewed.
  
  
  RESULTS
  Progressive jaundice and abdominal pain were the most frequent symptoms, as well as weight loss, together with serological changes such as elevation of alkaline phosphatase, γ-glutamyl-transpeptidase and serum bilirubin. Two of them showed high serum immunoglobulin G4 (IgG4) levels. Both focal and diffuse changes were found on computed tomography and magnetic resonance imaging. Two of our patients underwent operation because of a high suspicion of malignant tumor, and steroid therapy was administered to the other three patients diagnosed as AIP. No relapse was observed during the follow-up duration of all the patients.
  
  
  CONCLUSIONS
  Although some recent advances have been made to help the diagnosis of AIP, the differentiation between AIP and pancreatic carcinoma is still a challenge. Clinicians must remember to exclude AIP before making a diagnosis of pancreatic carcinoma.
authors.affiliation: Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Pei Li
authors.initials: PL
authors.lastname: Gong
authors.forename: Tao Tao
authors.initials: TT
authors.lastname: Liu
authors.forename: Xi Zhong
authors.initials: XZ
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007565:Jaundice / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010195:Pancreatitis / Q000175:diagnosis* / Q000276:immunology
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G