title: Major and minor duodenal papillae in autoimmune pancreatitis.
abstract: OBJECTIVE
  The objective of this study was to evaluate picture of the major and minor duodenal papillae in patients with autoimmune pancreatitis (AIP).
  
  
  METHODS
  Endoscopic features of the major and minor papillae were examined in 59 and 13 patients with AIP. After steroid therapy, changes of the major and minor papillae were observed in 5 and 6 patients. The major and minor papillae were observed with narrow band imaging in 24 and 6 patients. Biopsy specimens from the major (n = 50) and minor (n = 13) papillae were immunostained using an anti-IgG4 antibody.
  
  
  RESULTS
  Endoscopic features of the major and minor papillae were abnormal in 26 patients (44%; swelling [n = 20] and redness [n = 14]) and 5 patients (38%; swelling [n = 5]). Swelling of the pancreatic head, irregular narrowing of the main pancreatic duct of the pancreatic head, stenosis of the lower bile duct, and abundant infiltration of IgG4-positive plasma cells were more frequent in the patients with an abnormal major papilla compared with those with a normal major papilla. On narrow band imaging, dilated vessels were observed in abnormal papillae. After therapy, swelling of the major and minor papillae improved in all 4 and 2 patients.
  
  
  CONCLUSIONS
  Endoscopic features of the major and minor papillae were abnormal in 44% and 38% of the patients with AIP.
authors: From the Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
authors: Kazuro
authors: K
authors: Chiba
authors: Terumi
authors: T
authors: Kamisawa
authors: Sawako
authors: S
authors: Kuruma
authors: Susumu
authors: S
authors: Iwasaki
authors: Taku
authors: T
authors: Tabata
authors: Satomi
authors: S
authors: Koizumi
authors: Yuka
authors: Y
authors: Endo
authors: Go
authors: G
authors: Kuwata
authors: Takashi
authors: T
authors: Fujiwara
authors: Takeo
authors: T
authors: Arakawa
authors: Koichi
authors: K
authors: Koizumi
authors: Kumiko
authors: K
authors: Momma
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004384:Duodenoscopy; D004487:Edema / Q000209:etiology / Q000473:pathology; D004890:Erythema / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010183:Pancreatic Ducts / Q000473:pathology*; D010195:Pancreatitis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents