Publication details
Autoimunitní pankreatitida – diagnostický konsenzus
| Title in English | Autoimmune pancreatitis - diagnostic consensus |
|---|---|
| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Vnitřní lékařství |
| MU Faculty or unit | |
| Citation | |
| Field | Other specializations of internal medicine |
| Keywords | autoimmune pancreatitis; CT/MRI ; endoscopic retrograde cholangio-pancreatography; granulocytic endothelial lesion (GEL); immunoglobulin G4; MRCP; steroids |
| Description | The autoimmune type of pancreatitis represents the specific disease of pancreas, with significant contribution of autoimmune processes in its etiopathogenesis. Currently, there are two proved subtypes of this particular pancre-atopathy, which are defined clinically, histomorphologically and serologically. They have many histomorphologi-cal signs in common, but differ in the presence of so-called granulocytic epithelial lesions (GEL), which are absent in subtype 1. The subtype 1 is characterized by the presence of gammaglobulines, esp. immunoglobuline G4 and lgG4 positive extrapancreatic lesions. The subtype 2 is typically associated with the inflammatory bowel diseases, esp. ulcerative colitis. But the common characteristic of both subtypes is the fact response to applied steroid treat¬ment. Due to diverse diagnostic criteria in the past, in 2011 the consensus for the diagnosis of autoimmune pan¬creatitis was announced. It is based on clinical symptoms, biochemical results, the results got by using of imaging methods, histomorphology and positive response to steroid treatment. The matter to be solved is the question of early differential diagnosis between focal autoimmune pancreatitis and adenocarcinoma of pancreatic head. From imaging methods are MRI/CT, MRCP (in Asia ERCP), EUS with targeted biopsy of the gland (under EUS control), are recommended as the methods of choice. |