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Pancreas

Histological diagnostic criteria for autoimmune pancreatitis

Nature Reviews Gastroenterology & Hepatology volume 9, pages 8–10 (2012)Cite this article

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Autoimmune pancreatitis (AIP) is becoming increasingly recognized as a unique form of chronic pancreatitis. Its diagnosis, based on clinical and pathological parameters, is challenging. AIP is currently divided clinicopathologically into type 1 and type 2. Histological diagnostic criteria for type 1 and type 2 AIP have now been proposed by an international consensus study.

Autoimmune pancreatitis (AIP) is a unique form of pancreatitis with a presumed autoimmune etiology.1 The characteristic histological pattern of AIP was described in 1991 as lymphoplasmacytic sclerosing pancreatitis (LPSP) with numerous lymphoplasmacytic cell infiltrates, acinar atrophy, interlobular fibrosis and obliterative phlebitis.2 The classic concept of AIP—now designated as type 1 AIP—is as follows: elderly male preponderance; diffuse enlargement of the pancreas and irregular narrowing of the main pancreatic duct; increased levels of serum γ-globulin, increased IgG or IgG4 levels, or the presence of autoantibodies; histological findings of LPSP; frequent association with other sclerosing diseases; frequent symptoms of obstructive jaundice without an acute attack of pancreatitis; and steroid responsiveness.1 AIP is currently considered as a pancreatic manifestation of IgG4-related sclerosing disease.1

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Authors and Affiliations

  1. Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, 113-8677, Tokyo, Japan

    Terumi Kamisawa

  2. Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, 980-8574, Sendai, Japan

    Tooru Shimosegawa

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  1. Terumi Kamisawa
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  2. Tooru Shimosegawa
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Correspondence to Terumi Kamisawa.

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Kamisawa, T., Shimosegawa, T. Histological diagnostic criteria for autoimmune pancreatitis. Nat Rev Gastroenterol Hepatol 9, 8–10 (2012). https://doi.org/10.1038/nrgastro.2011.245

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