Autoimmune pancreatitis natural history, complications and prognosis: Difference between revisions
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**Approximately 25% may require a second course of [[glucocorticoids]]. | **Approximately 25% may require a second course of [[glucocorticoids]]. | ||
**A few patients with autoimmune pancreatitis may require continuous treatment | **A few patients with autoimmune pancreatitis may require continuous treatment | ||
* Patients with biliary strictures have a variable response to [[glucocorticoids]] such as:<ref name="pmid18222442">{{cite journal |vauthors=Ghazale A, Chari ST, Zhang L, Smyrk TC, Takahashi N, Levy MJ, Topazian MD, Clain JE, Pearson RK, Petersen BT, Vege SS, Lindor K, Farnell MB |title=Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy |journal=Gastroenterology |volume=134 |issue=3 |pages=706–15 |year=2008 |pmid=18222442 |doi=10.1053/j.gastro.2007.12.009 |url=}}</ref><ref name="pmid19345283">{{cite journal |vauthors=Sandanayake NS, Church NI, Chapman MH, Johnson GJ, Dhar DK, Amin Z, Deheragoda MG, Novelli M, Winstanley A, Rodriguez-Justo M, Hatfield AR, Pereira SP, Webster GJ |title=Presentation and management of post-treatment relapse in autoimmune pancreatitis/immunoglobulin G4-associated cholangitis |journal=Clin. Gastroenterol. Hepatol. |volume=7 |issue=10 |pages=1089–96 |year=2009 |pmid=19345283 |doi=10.1016/j.cgh.2009.03.021 |url=}}</ref><ref name="pmid16843735">{{cite journal |vauthors=Chari ST, Smyrk TC, Levy MJ, Topazian MD, Takahashi N, Zhang L, Clain JE, Pearson RK, Petersen BT, Vege SS, Farnell MB |title=Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience |journal=Clin. Gastroenterol. Hepatol. |volume=4 |issue=8 |pages=1010–6; quiz 934 |year=2006 |pmid=16843735 |doi=10.1016/j.cgh.2006.05.017 |url=}}</ref><ref name="pmid15545176">{{cite journal |vauthors=Kamisawa T, Egawa N, Nakajima H, Tsuruta K, Okamoto A |title=Morphological changes after steroid therapy in autoimmune pancreatitis |journal=Scand. J. Gastroenterol. |volume=39 |issue=11 |pages=1154–8 |year=2004 |pmid=15545176 |doi=10.1080/00365520410008033 |url=}}</ref><ref name="pmid15632697">{{cite journal |vauthors=Wakabayashi T, Kawaura Y, Satomura Y, Watanabe H, Motoo Y, Sawabu N |title=Long-term prognosis of duct-narrowing chronic pancreatitis: strategy for steroid treatment |journal=Pancreas |volume=30 |issue=1 |pages=31–9 |year=2005 |pmid=15632697 |doi= |url=}}</ref> | |||
** Patients with biliary strictures may respond to [[glucocorticoids]]. | |||
** Patients with biliary strictures may not respond to [[glucocorticoids]]. | |||
** Patients with biliary strictures may have an incomplete response to [[glucocorticoids]]. | |||
** Patients with biliary strictures may require maintenance therapy with [[glucocorticoids]] to prevent relapse. | |||
** Patients with biliary strictures may require maintenance therapy with [[glucocorticoids]] and/or [[immunomodulatory]] drugs to prevent [[relapse]]. | |||
==References== | ==References== | ||
Revision as of 18:22, 5 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
Overview
Natural History, Complications, and Prognosis
Natural History
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Complications
- Common complications of autoimmune pancreatitis may include:
- Pancreatic insufficiency
- Diabetes
- Pancreatic calcifications or stones
Prognosis
- The prognosis is usually good and following responses have been observed in response to corticosteroid therapy:
- About 2/3rd of patients show good response to glucocorticoids with complete recovery.[1][2][3]
- Approximately 25% may require a second course of glucocorticoids.
- A few patients with autoimmune pancreatitis may require continuous treatment
- Patients with biliary strictures have a variable response to glucocorticoids such as:[1][3][4][5][6]
- Patients with biliary strictures may respond to glucocorticoids.
- Patients with biliary strictures may not respond to glucocorticoids.
- Patients with biliary strictures may have an incomplete response to glucocorticoids.
- Patients with biliary strictures may require maintenance therapy with glucocorticoids to prevent relapse.
- Patients with biliary strictures may require maintenance therapy with glucocorticoids and/or immunomodulatory drugs to prevent relapse.
References
- ↑ 1.0 1.1 Ghazale A, Chari ST, Zhang L, Smyrk TC, Takahashi N, Levy MJ, Topazian MD, Clain JE, Pearson RK, Petersen BT, Vege SS, Lindor K, Farnell MB (2008). "Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy". Gastroenterology. 134 (3): 706–15. doi:10.1053/j.gastro.2007.12.009. PMID 18222442.
- ↑ Raina A, Yadav D, Krasinskas AM, McGrath KM, Khalid A, Sanders M, Whitcomb DC, Slivka A (2009). "Evaluation and management of autoimmune pancreatitis: experience at a large US center". Am. J. Gastroenterol. 104 (9): 2295–306. doi:10.1038/ajg.2009.325. PMID 19532132.
- ↑ 3.0 3.1 Sandanayake NS, Church NI, Chapman MH, Johnson GJ, Dhar DK, Amin Z, Deheragoda MG, Novelli M, Winstanley A, Rodriguez-Justo M, Hatfield AR, Pereira SP, Webster GJ (2009). "Presentation and management of post-treatment relapse in autoimmune pancreatitis/immunoglobulin G4-associated cholangitis". Clin. Gastroenterol. Hepatol. 7 (10): 1089–96. doi:10.1016/j.cgh.2009.03.021. PMID 19345283.
- ↑ Chari ST, Smyrk TC, Levy MJ, Topazian MD, Takahashi N, Zhang L, Clain JE, Pearson RK, Petersen BT, Vege SS, Farnell MB (2006). "Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience". Clin. Gastroenterol. Hepatol. 4 (8): 1010–6, quiz 934. doi:10.1016/j.cgh.2006.05.017. PMID 16843735.
- ↑ Kamisawa T, Egawa N, Nakajima H, Tsuruta K, Okamoto A (2004). "Morphological changes after steroid therapy in autoimmune pancreatitis". Scand. J. Gastroenterol. 39 (11): 1154–8. doi:10.1080/00365520410008033. PMID 15545176.
- ↑ Wakabayashi T, Kawaura Y, Satomura Y, Watanabe H, Motoo Y, Sawabu N (2005). "Long-term prognosis of duct-narrowing chronic pancreatitis: strategy for steroid treatment". Pancreas. 30 (1): 31–9. PMID 15632697.