Autoimmune pancreatitis in patients resected for focal pancreatic lesion – first results

Czech version

Authors: P. Mačinga ¹; J. Malušková ²; M. Oliverius ³; J. Špičák ¹; T. Hucl ¹
Authors‘ workplace: Klinika hepatogastroenterologie, IKEM, Praha ¹; Oddělení patologie, IKEM, Praha ²; Klinika transplantační chirurgie, IKEM, Praha ³
Published in: Gastroent Hepatol 2014; 68(4): 340-345
Category: Clinical and Experimental Gastroenterology: Original Article

Overview

Autoimmune pancreatitis (AIP) is a rare disease that may present with signs and symptoms mimicking pancreatic cancer (PC). AIP is characterized by a dramatic response to corticosteroid therapy. Despite the availability of well-defined AIP diagnosis criteria, a large portion of AIP patients is still indicated for unnecessary resection surgery.

Aim:
To assess the proportion of AIP in all pancreatic resections performed in the Institute of Clinical and Experimental Medicine for suspected focal pancreatic and to determine the clinical characteristics of this subgroup.

Methods:
A retrospective analysis of the data of all patients who underwent pancreatic resection in the Institute of Clinical and Experimental Medicine for suspected cancer between January 2000 and July 2013.

Results:
Two hundred and ninety-five pancreatic resections were performed in 201 males and 94 females (the mean age of patients was 60 years, range 36–78 years). In 15 patients (5.1%, 12 males, 3 females, average age 55), AIP was diagnosed based on the histology of the resected specimen. In six AIP patients (40%, all males, 3 AIP type 1, 3 AIP type 2), pancreatic adenocarcinoma (PC) was also present in the resected tissue. Except for higher age and new-onset diabetes in the group with PC, no significant differences were observed in the preoperative characteristics of patients with AIP with and without cancer. The diagnosis of AIP was not made in any of the patients prior to surgery; however, the diagnostic algorithm was not fully completed.

Conclusion:
The considerable number of cases of AIP found in pancreas tissue resected for focal pancreatic lesion confirms the challenge of AIP diagnostics. The high incidence of PC in patients with AIP should draw attention to the possibility of synchronous AIP and PC occurrence; it may also indicate the possibility of AIP being a risk factor of PC. Patients with AIP and PC were older and were diagnosed with new-onset diabetes mellitus more frequently.

Key words:
autoimmune pancreatitis – pancreatic cancer – diabetes mellitus

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
28. 7. 2014

Accepted:
11. 8. 2014

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