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©2014 Baishideng Publishing Group Inc.
World J Gastrointest Pathophysiol. May 15, 2014; 5(2): 71-81
Published online May 15, 2014. doi: 10.4291/wjgp.v5.i2.71
Published online May 15, 2014. doi: 10.4291/wjgp.v5.i2.71
Type 1 AIP | ||
Criterion | Level 1 | Level 2 |
Parenchymal imaging | Typical: Diffuse enlargement with delayed enhancement | Indeterminate: Focal enlargement with delayed enhancement |
Ductal imaging (ERP) | Long or multiple strictures (> 1/3 duct length) without upstream dilatation | Focal narrowing without upstream dilatation (< 5 mm) |
Serology | IgG4 > 2x upper limit | IgG4 1-2x upper limit |
Other organ involvement | Extrapancreatic organ histology. Any 3 of : 1 Lymphoplasmacytic infiltration with fibrosis and without granulocytic infiltration 2 Storiform fibrosis 3 Obliterative phlebitis 4 > 10 cells/HPF IgG4-positive cells Typical radiology. Any one of: 1 Segmental/multiple proximal or distal biliary stricture 2 Retroperitoneal fibrosis | Extrapancreatic organ histology including bile duct biopsies. Both of: 1 Marked lymphoplasmacytic infiltration without granulocytic infiltration 2 10 cells/HPF IgG4-positive cells Physical or radiological evidence of at least one of: 1 Enlarged salivary/lachrymal glands 2 Renal involvement |
Histology of pancreas | LPSP and 3 of: 1 Periductal lymphoplasmacytic infiltrate without granulocytic infiltration 2 Obliterative phlebitis 3 Storiform fibrosis 4 > 10 cells/HPF IgG4-positive cells | LPSP and 2 of: 1 Periductal lymphoplasmacytic infiltrate without granulocytic infil tration 2 Obliterative phlebitis 3 Storiform fibrosis 4 > 10 cells/HPF IgG4-positive cells |
Response to steroid (Rt) | Rapid (< 2 wk) radiological demonstration of marked improvement in pancreatic/extrapancreatic manifestations | |
Type 2 AIP | ||
Parenchymal imaging | Typical: Diffuse enlargement with delayed enhancement | Indeterminate: Focal enlargement with delayed enhancement |
Ductal Imaging (ERCP) | Long (> 1/3 duct length) or multiple strictures without upstream dilatation | Focal narrowing without marked upstream dilatation (< 5 mm) |
Other organ involvement | Clinically diagnosed inflammatory bowel disease | |
Histology of pancreas | IDCP. Both of: 1 Granulocytic infiltration of duct wall with or without acinar inflammation 2 0-10 cells/HPF IgG4-positive cells | Both of : 1 Granulocytic and lymphoplasmacytic acinar infiltrate 2 0-10 cells/HPF IgG4-positive cells |
Response to steroid (Rt) | Rapid (< 2 wk) radiological demonstration of marked improvement in manifestations |
- Citation: O’Reilly DA, Malde DJ, Duncan T, Rao M, Filobbos R. Review of the diagnosis, classification and management of autoimmune pancreatitis. World J Gastrointest Pathophysiol 2014; 5(2): 71-81
- URL: https://www.wjgnet.com/2150-5330/full/v5/i2/71.htm
- DOI: https://dx.doi.org/10.4291/wjgp.v5.i2.71