Diagnostic and therapeutic considerations in biopsy‐proven type 2 autoimmune pancreatitis: comparative analysis with biopsy‐proven type 1 autoimmune pancreatitis
Background Autoimmune processes are now an increasingly recognized cause of acute and chronic pancreatitis. Autoimmune pancreatitis is a rare, benign pathology with two distinct clinicopathologic subtypes. The aim of this study was to compare the presentation, diagnostic considerations and outcomes...
Gespeichert in:
| Veröffentlicht in: | ANZ journal of surgery 2021-05, Vol.91 (5), p.907-914 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 914 |
|---|---|
| container_issue | 5 |
| container_start_page | 907 |
| container_title | ANZ journal of surgery |
| container_volume | 91 |
| creator | Pattabathula, Krishna Waters, Peadar S. Hwang, Jason Bettington, Mark Singh, Mahendra Bryant, Richard D. Cavallucci, David J. O'Rourke, Nicholas |
| description | Background
Autoimmune processes are now an increasingly recognized cause of acute and chronic pancreatitis. Autoimmune pancreatitis is a rare, benign pathology with two distinct clinicopathologic subtypes. The aim of this study was to compare the presentation, diagnostic considerations and outcomes of patients with biopsy‐proven type 1 and 2 autoimmune pancreatitis (AIP).
Methods
A retrospective review of the Queensland Health pathology database of histologically proven AIP was conducted. Parameters compared included demographics, diagnostic criterion and post‐treatment outcomes.
Results
Twenty‐three patients had a confirmed histological diagnosis of AIP (type 1 = 13, type 2 = 10). Patients with type 2 AIP were younger (median age 49 versus 59 years, P |
| doi_str_mv | 10.1111/ans.16445 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2473402595</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2473402595</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3535-3c9344edb17b36a3c839ca503193da7cff6372f157466cbf519cd1cf5a918a253</originalsourceid><addsrcrecordid>eNp1kU1OwzAQRi0EoqWw4ALIEhtYFOKM7cTsKv6lChbAOnIcB1wlTogTUHYcgUtwMU6CSwsLRL2ZGenN01gfQrskOCL-HUvrjginlK2hIfFlHBIRrS97QgEGaMu5WRAQzgXbRAMA4CJm8RB9nBn5aCvXGoWlzXD7pBtZ624-q8o6k_m5Nb7DxuLUVLXrP9_e66Z60Ra3fa1xiGXXVqYsO6txLa1qtN9ojTvxhrKW8_0X7e2y6J1x-NW0T_-byCrTNtrIZeH0zrKO0MPF-f3p1Xh6e3l9OpmOFTBgY1ACKNVZSqIUuAQVg1CSBUAEZDJSec4hCnPCIsq5SnNGhMqIypkUJJYhgxE6WHj9Vc-ddm1SGqd0UUirq84lIY2ABiETc3T_Dzqrusb_0VMsjAlnNOKeOlxQqqmca3Se1I0pZdMnJEjm2SU-u-Q7O8_uLY1dWursl_wJywPHC-DVFLpfbUomN3cL5Rf6NamA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2528165476</pqid></control><display><type>article</type><title>Diagnostic and therapeutic considerations in biopsy‐proven type 2 autoimmune pancreatitis: comparative analysis with biopsy‐proven type 1 autoimmune pancreatitis</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Pattabathula, Krishna ; Waters, Peadar S. ; Hwang, Jason ; Bettington, Mark ; Singh, Mahendra ; Bryant, Richard D. ; Cavallucci, David J. ; O'Rourke, Nicholas</creator><creatorcontrib>Pattabathula, Krishna ; Waters, Peadar S. ; Hwang, Jason ; Bettington, Mark ; Singh, Mahendra ; Bryant, Richard D. ; Cavallucci, David J. ; O'Rourke, Nicholas</creatorcontrib><description>Background
Autoimmune processes are now an increasingly recognized cause of acute and chronic pancreatitis. Autoimmune pancreatitis is a rare, benign pathology with two distinct clinicopathologic subtypes. The aim of this study was to compare the presentation, diagnostic considerations and outcomes of patients with biopsy‐proven type 1 and 2 autoimmune pancreatitis (AIP).
Methods
A retrospective review of the Queensland Health pathology database of histologically proven AIP was conducted. Parameters compared included demographics, diagnostic criterion and post‐treatment outcomes.
Results
Twenty‐three patients had a confirmed histological diagnosis of AIP (type 1 = 13, type 2 = 10). Patients with type 2 AIP were younger (median age 49 versus 59 years, P < 0.05). There was no significant difference in gender distribution of disease at presentation. Type 2 AIP presented with significant increased focal pancreatic changes on cross‐sectional imaging (80% versus 54%, P < 0.05). Serum IgG4 levels were raised (>1.40 g/L) in 69% of patients with type 1 AIP and not detected in type 2 (P < 0.01). Concurrent underlying inflammatory bowel disease was present in a higher proportion of type 2 AIP (40% versus 15%, P < 0.05). A significantly increased proportion of patients with type 2 AIP underwent surgical resection (70% versus 30%, P < 0.05). Conservative management was utilized in more patients with type 1 disease (54% versus 30%). On follow‐up, two patients have experienced symptomatic relapse at 6–18 months.
Conclusions
Diagnostic challenges do exist and clinicians must suspect 2 type AIP in young, serum IgG4‐negative inflammatory bowel disease patients with recurrent pancreatitis.
Diagnostic challenges do exist in type 2 autoimmune pancreatitis (AIP). Patients with type 2 AIP were significantly younger, with focal disease on cross‐sectional imaging, without elevation of igG4 levels, with concurrent inflammatory bowel disease and required more operative intervention. There was no significant difference observe in relapse rates and gender at presentation. Clinicians must suspect 2 type AIP in young, serum IgG4‐negative inflammatory bowel disease patients with recurrent pancreatitis.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.16445</identifier><identifier>PMID: 33369858</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>autoimmune disease ; autoimmune pancreatitis ; Biopsy ; Comparative analysis ; Demographics ; Demography ; Diagnostic systems ; idiopathic duct‐centric pancreatitis ; IgG4 disease ; Immunoglobulin G ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Intestine ; Pancreas ; pancreatic adenocarcinoma ; Pancreatic cancer ; Pancreatitis ; Pathology ; type 2 autoimmune pancreatitis</subject><ispartof>ANZ journal of surgery, 2021-05, Vol.91 (5), p.907-914</ispartof><rights>2020 Royal Australasian College of Surgeons</rights><rights>2020 Royal Australasian College of Surgeons.</rights><rights>2021 Royal Australasian College of Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3535-3c9344edb17b36a3c839ca503193da7cff6372f157466cbf519cd1cf5a918a253</citedby><cites>FETCH-LOGICAL-c3535-3c9344edb17b36a3c839ca503193da7cff6372f157466cbf519cd1cf5a918a253</cites><orcidid>0000-0001-8438-968X ; 0000-0003-2947-9206</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.16445$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.16445$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33369858$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pattabathula, Krishna</creatorcontrib><creatorcontrib>Waters, Peadar S.</creatorcontrib><creatorcontrib>Hwang, Jason</creatorcontrib><creatorcontrib>Bettington, Mark</creatorcontrib><creatorcontrib>Singh, Mahendra</creatorcontrib><creatorcontrib>Bryant, Richard D.</creatorcontrib><creatorcontrib>Cavallucci, David J.</creatorcontrib><creatorcontrib>O'Rourke, Nicholas</creatorcontrib><title>Diagnostic and therapeutic considerations in biopsy‐proven type 2 autoimmune pancreatitis: comparative analysis with biopsy‐proven type 1 autoimmune pancreatitis</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
Autoimmune processes are now an increasingly recognized cause of acute and chronic pancreatitis. Autoimmune pancreatitis is a rare, benign pathology with two distinct clinicopathologic subtypes. The aim of this study was to compare the presentation, diagnostic considerations and outcomes of patients with biopsy‐proven type 1 and 2 autoimmune pancreatitis (AIP).
Methods
A retrospective review of the Queensland Health pathology database of histologically proven AIP was conducted. Parameters compared included demographics, diagnostic criterion and post‐treatment outcomes.
Results
Twenty‐three patients had a confirmed histological diagnosis of AIP (type 1 = 13, type 2 = 10). Patients with type 2 AIP were younger (median age 49 versus 59 years, P < 0.05). There was no significant difference in gender distribution of disease at presentation. Type 2 AIP presented with significant increased focal pancreatic changes on cross‐sectional imaging (80% versus 54%, P < 0.05). Serum IgG4 levels were raised (>1.40 g/L) in 69% of patients with type 1 AIP and not detected in type 2 (P < 0.01). Concurrent underlying inflammatory bowel disease was present in a higher proportion of type 2 AIP (40% versus 15%, P < 0.05). A significantly increased proportion of patients with type 2 AIP underwent surgical resection (70% versus 30%, P < 0.05). Conservative management was utilized in more patients with type 1 disease (54% versus 30%). On follow‐up, two patients have experienced symptomatic relapse at 6–18 months.
Conclusions
Diagnostic challenges do exist and clinicians must suspect 2 type AIP in young, serum IgG4‐negative inflammatory bowel disease patients with recurrent pancreatitis.
Diagnostic challenges do exist in type 2 autoimmune pancreatitis (AIP). Patients with type 2 AIP were significantly younger, with focal disease on cross‐sectional imaging, without elevation of igG4 levels, with concurrent inflammatory bowel disease and required more operative intervention. There was no significant difference observe in relapse rates and gender at presentation. Clinicians must suspect 2 type AIP in young, serum IgG4‐negative inflammatory bowel disease patients with recurrent pancreatitis.</description><subject>autoimmune disease</subject><subject>autoimmune pancreatitis</subject><subject>Biopsy</subject><subject>Comparative analysis</subject><subject>Demographics</subject><subject>Demography</subject><subject>Diagnostic systems</subject><subject>idiopathic duct‐centric pancreatitis</subject><subject>IgG4 disease</subject><subject>Immunoglobulin G</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Intestine</subject><subject>Pancreas</subject><subject>pancreatic adenocarcinoma</subject><subject>Pancreatic cancer</subject><subject>Pancreatitis</subject><subject>Pathology</subject><subject>type 2 autoimmune pancreatitis</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kU1OwzAQRi0EoqWw4ALIEhtYFOKM7cTsKv6lChbAOnIcB1wlTogTUHYcgUtwMU6CSwsLRL2ZGenN01gfQrskOCL-HUvrjginlK2hIfFlHBIRrS97QgEGaMu5WRAQzgXbRAMA4CJm8RB9nBn5aCvXGoWlzXD7pBtZ624-q8o6k_m5Nb7DxuLUVLXrP9_e66Z60Ra3fa1xiGXXVqYsO6txLa1qtN9ojTvxhrKW8_0X7e2y6J1x-NW0T_-byCrTNtrIZeH0zrKO0MPF-f3p1Xh6e3l9OpmOFTBgY1ACKNVZSqIUuAQVg1CSBUAEZDJSec4hCnPCIsq5SnNGhMqIypkUJJYhgxE6WHj9Vc-ddm1SGqd0UUirq84lIY2ABiETc3T_Dzqrusb_0VMsjAlnNOKeOlxQqqmca3Se1I0pZdMnJEjm2SU-u-Q7O8_uLY1dWursl_wJywPHC-DVFLpfbUomN3cL5Rf6NamA</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Pattabathula, Krishna</creator><creator>Waters, Peadar S.</creator><creator>Hwang, Jason</creator><creator>Bettington, Mark</creator><creator>Singh, Mahendra</creator><creator>Bryant, Richard D.</creator><creator>Cavallucci, David J.</creator><creator>O'Rourke, Nicholas</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8438-968X</orcidid><orcidid>https://orcid.org/0000-0003-2947-9206</orcidid></search><sort><creationdate>202105</creationdate><title>Diagnostic and therapeutic considerations in biopsy‐proven type 2 autoimmune pancreatitis: comparative analysis with biopsy‐proven type 1 autoimmune pancreatitis</title><author>Pattabathula, Krishna ; Waters, Peadar S. ; Hwang, Jason ; Bettington, Mark ; Singh, Mahendra ; Bryant, Richard D. ; Cavallucci, David J. ; O'Rourke, Nicholas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3535-3c9344edb17b36a3c839ca503193da7cff6372f157466cbf519cd1cf5a918a253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>autoimmune disease</topic><topic>autoimmune pancreatitis</topic><topic>Biopsy</topic><topic>Comparative analysis</topic><topic>Demographics</topic><topic>Demography</topic><topic>Diagnostic systems</topic><topic>idiopathic duct‐centric pancreatitis</topic><topic>IgG4 disease</topic><topic>Immunoglobulin G</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Intestine</topic><topic>Pancreas</topic><topic>pancreatic adenocarcinoma</topic><topic>Pancreatic cancer</topic><topic>Pancreatitis</topic><topic>Pathology</topic><topic>type 2 autoimmune pancreatitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pattabathula, Krishna</creatorcontrib><creatorcontrib>Waters, Peadar S.</creatorcontrib><creatorcontrib>Hwang, Jason</creatorcontrib><creatorcontrib>Bettington, Mark</creatorcontrib><creatorcontrib>Singh, Mahendra</creatorcontrib><creatorcontrib>Bryant, Richard D.</creatorcontrib><creatorcontrib>Cavallucci, David J.</creatorcontrib><creatorcontrib>O'Rourke, Nicholas</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pattabathula, Krishna</au><au>Waters, Peadar S.</au><au>Hwang, Jason</au><au>Bettington, Mark</au><au>Singh, Mahendra</au><au>Bryant, Richard D.</au><au>Cavallucci, David J.</au><au>O'Rourke, Nicholas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic and therapeutic considerations in biopsy‐proven type 2 autoimmune pancreatitis: comparative analysis with biopsy‐proven type 1 autoimmune pancreatitis</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2021-05</date><risdate>2021</risdate><volume>91</volume><issue>5</issue><spage>907</spage><epage>914</epage><pages>907-914</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
Autoimmune processes are now an increasingly recognized cause of acute and chronic pancreatitis. Autoimmune pancreatitis is a rare, benign pathology with two distinct clinicopathologic subtypes. The aim of this study was to compare the presentation, diagnostic considerations and outcomes of patients with biopsy‐proven type 1 and 2 autoimmune pancreatitis (AIP).
Methods
A retrospective review of the Queensland Health pathology database of histologically proven AIP was conducted. Parameters compared included demographics, diagnostic criterion and post‐treatment outcomes.
Results
Twenty‐three patients had a confirmed histological diagnosis of AIP (type 1 = 13, type 2 = 10). Patients with type 2 AIP were younger (median age 49 versus 59 years, P < 0.05). There was no significant difference in gender distribution of disease at presentation. Type 2 AIP presented with significant increased focal pancreatic changes on cross‐sectional imaging (80% versus 54%, P < 0.05). Serum IgG4 levels were raised (>1.40 g/L) in 69% of patients with type 1 AIP and not detected in type 2 (P < 0.01). Concurrent underlying inflammatory bowel disease was present in a higher proportion of type 2 AIP (40% versus 15%, P < 0.05). A significantly increased proportion of patients with type 2 AIP underwent surgical resection (70% versus 30%, P < 0.05). Conservative management was utilized in more patients with type 1 disease (54% versus 30%). On follow‐up, two patients have experienced symptomatic relapse at 6–18 months.
Conclusions
Diagnostic challenges do exist and clinicians must suspect 2 type AIP in young, serum IgG4‐negative inflammatory bowel disease patients with recurrent pancreatitis.
Diagnostic challenges do exist in type 2 autoimmune pancreatitis (AIP). Patients with type 2 AIP were significantly younger, with focal disease on cross‐sectional imaging, without elevation of igG4 levels, with concurrent inflammatory bowel disease and required more operative intervention. There was no significant difference observe in relapse rates and gender at presentation. Clinicians must suspect 2 type AIP in young, serum IgG4‐negative inflammatory bowel disease patients with recurrent pancreatitis.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>33369858</pmid><doi>10.1111/ans.16445</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8438-968X</orcidid><orcidid>https://orcid.org/0000-0003-2947-9206</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1445-1433 |
| ispartof | ANZ journal of surgery, 2021-05, Vol.91 (5), p.907-914 |
| issn | 1445-1433 1445-2197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2473402595 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | autoimmune disease autoimmune pancreatitis Biopsy Comparative analysis Demographics Demography Diagnostic systems idiopathic duct‐centric pancreatitis IgG4 disease Immunoglobulin G Inflammatory bowel disease Inflammatory bowel diseases Intestine Pancreas pancreatic adenocarcinoma Pancreatic cancer Pancreatitis Pathology type 2 autoimmune pancreatitis |
| title | Diagnostic and therapeutic considerations in biopsy‐proven type 2 autoimmune pancreatitis: comparative analysis with biopsy‐proven type 1 autoimmune pancreatitis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T14%3A39%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diagnostic%20and%20therapeutic%20considerations%20in%20biopsy%E2%80%90proven%20type%202%20autoimmune%20pancreatitis:%20comparative%20analysis%20with%20biopsy%E2%80%90proven%20type%201%20autoimmune%20pancreatitis&rft.jtitle=ANZ%20journal%20of%20surgery&rft.au=Pattabathula,%20Krishna&rft.date=2021-05&rft.volume=91&rft.issue=5&rft.spage=907&rft.epage=914&rft.pages=907-914&rft.issn=1445-1433&rft.eissn=1445-2197&rft_id=info:doi/10.1111/ans.16445&rft_dat=%3Cproquest_cross%3E2473402595%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2528165476&rft_id=info:pmid/33369858&rfr_iscdi=true |