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Article Dans Une Revue Alimentary Pharmacology and Therapeutics Année : 2010

Review article: autoimmune pancreatitis - management of an emerging disease

Résumé

Background Autoimmune pancreatitis (AIP) is a steroid-responsive inflammatory pancreatic disease considered to be part of an immunoglobulin G4 (IgG4)-associated systemic disease. Aim To review the management of AIP. Methods We conducted a PubMed search using the following key words: autoimmune pancreatitis, IgG4-associated systemic disease, IgG4-associated cholangitis, natural history, treatment. Results Although there are reports of spontaneous resolution of AIP, steroids have been shown to be effective in inducing remission, reducing the frequency of relapse, and that of long-term unfavourable events compared to historical controls. There are no randomized data on AIP treatment. Oral steroids are used for induction of remission. Reported response results are excellent with variable proportions of patients achieving remission in different studies. After a period of 2-4 weeks, steroids are tapered and usually withdrawn within several months, although long-term maintenance therapy for all AIP patients has also been proposed. Disease relapse occurs in more than 40% of patients and can be effectively treated with additional immunosuppression, including azathioprine. Conclusion Steroids are effective in inducing remission and treating relapse in patients with AIP. Randomized trials on AIP therapy are lacking. To date, questions concerning the timing, choice, and duration of long-term immunosuppression remain unanswered.

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Dates et versions

hal-00599509 , version 1 (10-06-2011)

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Evangelos Kalaitzakis, George Jm Webster. Review article: autoimmune pancreatitis - management of an emerging disease. Alimentary Pharmacology and Therapeutics, 2010, 33 (3), pp.291. ⟨10.1111/j.1365-2036.2010.04526.x⟩. ⟨hal-00599509⟩

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