Lobularity in Autoimmune Pancreatitis Was A Steroid-Therapy Responding Endoscopic Ultrasound Finding

Area of Science:

• Gastroenterology
• Medical Imaging
• Immunology

Background:

• Endoscopic ultrasound (EUS) assesses morphological changes in pancreatic diseases.
• Autoimmune pancreatitis (AIP) is a challenging pancreatic condition.
• Steroid therapy is a primary treatment for AIP.

Purpose of the Study:

• To identify changes in EUS findings of AIP during steroid therapy.
• To correlate EUS findings with histopathology in AIP.

Main Methods:

• EUS performed on 37 AIP patients before and after 2 weeks of steroid therapy.
• Comparison of EUS and histopathological findings in 2 patients post-pancreatectomy.

Main Results:

• No significant change in hyperechoic strands or hypoechoic swelling post-therapy.
• Significant decrease in lobularity prevalence from 48.6% to 21.6% after steroid therapy.
• Lobularity correlated with storiform fibrosis and IgG4-positive plasma cell infiltration.

Conclusions:

• Lobularity is the most responsive EUS finding to steroid therapy in AIP.
• Focal lobularity reflects storiform fibrosis and IgG4-related inflammation.
• Findings may clarify the pathogenesis of steroid-responsive AIP.