title: Laparoscopic and Percutaneous Core Needle Biopsy Plays a Central Role for the Diagnosis of Autoimmune Pancreatitis in a Single-Center Study From Denmark.
abstract: OBJECTIVE
  The aims of this study were to describe the diagnosis of autoimmune pancreatitis (AIP) in Denmark and to test the usefulness of the International Consensus Diagnostic Criteria (ICDC) on a geographically well-defined cohort.
  
  
  METHODS
  All patients diagnosed with AIP at Odense University Hospital from 2007 to 2013 were included (n = 30; mean follow-up, 26.2 months). Data from laparoscopic or percutaneous ultrasound-guided core needle biopsy (CNB), resection specimens, endoscopic ultrasound (EUS), EUS-guided CNB, computed tomography, serum immunoglobulin G4 (IgG4), and pancreatography were retrospectively analyzed according to ICDC.
  
  
  RESULTS
  Twenty patients were diagnosed with type 1, 8 with type 2, and 2 with not otherwise specified AIP. Twenty-eight patients (93%) could correctly be classified when ICDC were retrospectively applied. Serum IgG4 was elevated in 44% of type 1 and 0% of type 2. Other organ involvement was observed in 40% of type 1 and 13% of type 2, but inflammatory bowel disease only in type 2 (P = 0.001). One patient had IgG4-related chronic perisplenitis as a hitherto undescribed manifestation of IgG4-related disease. Nineteen (91%) of 21 biopsied patients had diagnostic CNB features of AIP. Computed tomography, EUS, and pancreatography showed features highly suggestive or supportive of AIP in 68%, 72%, and 71%, respectively.
  
  
  CONCLUSIONS
  Laparoscopic or percutaneous ultrasound-guided CNB had the highest sensitivity for AIP. The ICDC could retrospectively correctly diagnose 93% of the patients.
authors: From the *Department of Pathology, †HPB Section, Department of Surgery, and ‡Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.
authors: Sönke
authors: S
authors: Detlefsen
authors: Michael Bau
authors: MB
authors: Mortensen
authors: Torsten Kjærulff
authors: TK
authors: Pless
authors: Anne-Sofie
authors: AS
authors: Cribe
authors: Ove B Schaffalitzky
authors: OB
authors: de Muckadell
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D003718:Denmark / Q000453:epidemiology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D011237:Predictive Value of Tests; D012008:Recurrence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents