Autoimmune pancreatitis: Cornerstones and future perspectives

Area of Science:

• Gastroenterology
• Immunology
• Pathology

Background:

• Autoimmune pancreatitis (AIP) is an immune-mediated pancreatic disease characterized by inflammation and fibrosis.
• AIP is increasingly diagnosed and often mistaken for other pancreatic conditions.
• It is classified into types 1 and 2, with emerging recognition of type 3 (immunotherapy-triggered).

Purpose of the Study:

• To review current knowledge on autoimmune pancreatitis, including epidemiology, etiology, clinical presentation, diagnosis, and treatment.
• To highlight diagnostic and therapeutic challenges, such as differentiating AIP from pancreatic cancer and managing long-term care.
• To emphasize the need for greater awareness and understanding of this complex autoimmune disorder.

Main Methods:

• Comprehensive literature review of autoimmune pancreatitis.
• Analysis of epidemiological data, etiological factors, and clinical manifestations.
• Evaluation of diagnostic criteria and treatment strategies, including steroid therapy and immunosuppressive agents.

Main Results:

• AIP presents with painless jaundice and weight loss; elevated serum IgG4 is characteristic of Type 1 AIP.
• Diagnosis requires integrating clinical, laboratory, radiological, and histological findings.
• Steroid therapy is effective for most AIP cases, with immunosuppressants used for severe instances.

Conclusions:

• Autoimmune pancreatitis requires increased clinical awareness due to its rising incidence and diagnostic complexities.
• Accurate diagnosis is crucial for effective management, distinguishing AIP from pancreatic cancer.
• Further research is needed to address controversies in AIP diagnosis and long-term treatment strategies.