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Review of the diagnosis classification and management of autoimmune pancreatitis

机译:自身免疫性胰腺炎的诊断分类和治疗方法综述

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摘要

Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, with as yet undetermined incidence and prevalence in the general population. Our understanding of it continues to evolve. In the last few years, 2 separate subtypes have been identified: type 1 AIP has been recognised as the pancreatic manifestation of a multiorgan disease, named immunoglobulin G4 (IgG4)-related disease while type 2 AIP is a pancreas specific disorder not associated with IgG4. International criteria for the diagnosis of AIP have been defined: the HISORt criteria from the Mayo clinic, the Japan consensus criteria and, most recently, the international association of pancreatology “International Consensus Diagnostic Criteria”. Despite this, in clinical practice it can still be very difficult to confirm the diagnosis and differentiate AIP from a pancreatic cancer. There are no large studies into the long-term prognosis and management of relapses of AIP, and there is even less information at present regarding the Type 2 AIP subtype. Further studies are necessary to clarify the pathogenesis, treatment and long-term outcomes of this disease. Critically for clinicians, making the correct diagnosis and differentiating the disease from pancreatic cancer is of the utmost importance and the greatest challenge.
机译:自身免疫性胰腺炎(AIP)是一种罕见的慢性胰腺炎,在一般人群中其发病率和患病率尚未确定。我们对它的理解在不断发展。在过去的几年中,已经确定了2种不同的亚型:1型AIP被认为是一种多器官疾病的胰腺表现,称为免疫球蛋白G4(IgG4)相关疾病,而2型AIP是一种胰腺特异性疾病,与IgG4不相关。已经定义了AIP诊断的国际标准:Mayo诊所的HISORt标准,日本共识标准以及最近的国际胰腺病学协会“国际共识诊断标准”。尽管如此,在临床实践中,仍然难以确定诊断并区分AIP和胰腺癌。关于AIP复发的长期预后和治疗尚无大量研究,关于2型AIP亚型的信息目前较少。需要进一步的研究来阐明这种疾病的发病机理,治疗方法和长期结果。对于临床医生而言,至关重要的是,做出正确的诊断并将疾病与胰腺癌区分开是最重要和最大的挑战。

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