The pancreas gland is an endocrine gland used to help digest fatty lipids; inflamation of this gland is called pancreatitis. Autoimmune Pancreatitis (AIP) is identified by using a number of different methods. AIP is a benign type of chronic pancreatitis that many in the medical profession advise treatment with corticosteroids in a minority of certain cases. IgG4 positive plasma cells can be detected in a number of tissues other than the pancreas in AIP patients. References: Kamisawa, T, Funata, N, Hayashi, Y, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol 2003; 38:982. Shinji, A, Sano, K, Hamano, H, et al. Autoimmune pancreatitis is closely associated with gastric ulcer presenting with abundant IgG4-bearing plasma cell infiltration. Gastrointest Endosc 2004; 59:506. Takeda, S, Haratake, J, Kasai, T, et al. IgG4-associated idiopathic tubulointerstitial nephritis complicating autoimmune pancreatitis. Nephrol Dial Transplant 2004; 19:474. Saeki, T, Saito, A, Hiura, T, et al. Lymphoplasmacytic infiltration of multiple organs with immunoreactivity for IgG4: IgG4-related systemic disease. Intern Med 2006; 45:163. Umemura, T, Zen, Y, Hamano, H, et al. Immunoglobin G4-hepatopathy: Association of immunoglobin G4-bearing plasma cells in liver with autoimmune pancreatitis. Hepatology 2007; 46:463.
Instructions
Methods of Detecting Autoimmune Pancreatitis
1. Diagnose this disease. Symptoms of Autoimmune Pancreatitis (AIP) include weight loss, nausea and mild abdominal pain. To confirm diagnosis imaging is done with a computer tomography scan (CT) and endoscopic retrograde cholangiopancreatogram (ERCP). An endoscope capable of taking internal x-rays is lowered through the mouth and down through to the bile and pancreatic ducts. A dye released from the endoscope allows x-rays of these organs to be taken. The radiologist will be looking for a "sausage shaped" enlarged pancreas and/or a diffusely narrow irregularly shaped pancreatic duct.
2. Identify the signs. Confirmation of AIP also takes place by EUS ( endoscopic ultrasound). Inserted into the digestive tract, an endoscope sends back ultrasonic images allowing the doctors to guide a hollow needle to retrieve a cylindrical tissue sample from the pancreas. Pathologists look for accumulated lymphocytes and plasmacytes in the tissue sample and tough fibers around ducts and veins.
3. Test the blood. Serum levels of IgG4 usually found in AIP patients cannot be relied upon entirely on their own as elevated levels of IgG4 are found in patients with pancreatic cancer and also some patients without AIP or pancreatic cancer; therefore several different tests are most reliable in the diagnoses of AIP.
Tags: Autoimmune Pancreatitis, found patients, levels IgG4, pancreatic cancer, plasma cells, tissue sample