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A comparative study of diagnostic scoring systems for autoimmune pancreatitis
Marianne J van Heerde1, Jorie Buijs, Erik A Rauws
1From the *Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam; †Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam; ‡Department of Pathology, Erasmus University Medical Center; and §Department of Pathology, Academic Medical Center, Amsterdam; ∥Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht; and ¶Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, the Netherlands.
Objective:
Several diagnostic scoring systems for autoimmune pancreatitis (AIP) have been proposed including the Asian, HISORt (Histology, Imaging, Serology, Other organ involvement and Response to therapy), and International Consensus Diagnostic Criteria (ICDC), which have been compared by a few studies. We evaluated the diagnostic performance of these criteria in patients diagnosed with AIP between May 1992 and August 2011.
Methods:
Scoring systems were applied retrospectively using data obtained in the initial evaluation period, before pancreatic resection was performed.
Results:
One hundred fourteen cases with AIP were included. Eighty-two percent met the diagnostic criteria for AIP according to either the Asian, HISORt, or ICDC criteria. Only 33% met the Asian criteria, probably mainly related to a low rate of diagnostic pancreatography. In 18%, all scoring systems failed to confirm the diagnosis, even though these patients were considered to have a firm diagnosis of AIP.
Conclusions:
In this cohort of AIP patients, the 3 major diagnostic scoring systems for AIP proved to be complementary rather than overlapping. Our data indicate that one-fifth of our AIP patients do not meet any of these scoring systems. The ICDC, Asian, and HISORt criteria should be considered as useful clinical tools but not as criterion standard for the diagnosis.
Related Concept Videos
Chronic Pancreatitis II: Collaborative Care
Assessment:
Acute Pancreatitis I: Introduction
Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Chronic Pancreatitis I: Introduction
Acute Pancreatitis II: Pathophysiology
Chronic Pancreatitis II: Pathophysiology

