Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 7-Day Trial for You or Your Team.

Learn More →

Close relationship between autoimmune pancreatitis and multifocal fibrosclerosis

Close relationship between autoimmune pancreatitis and multifocal fibrosclerosis Background: Autoimmune pancreatitis is a unique clinical entity proposed recently, and is sometimes associated with inflammation of other organs. Aims: To examine the pathophysiology of the pancreas and other organs in patients with autoimmune pancreatitis. Patients and methods: We evaluated clinicopathological findings in six resected and one autopsied patient with autoimmune pancreatitis. The pancreas, peripancreatic tissue, bile duct, and gall bladder were examined histologically and immunohistochemically. Biopsied salivary gland and cervical lymph node of one patient were also examined. We also performed similar immunohistochemical examinations in pancreatectomy specimens from 10 patients with alcoholic chronic pancreatitis and biopsied salivary glands from five patients with Sjögren’s syndrome. Results: Stenosis of the extrahepatic bile duct was detected in all patients. Histological findings were characterised by diffuse lymphoplasmacytic infiltration with marked interstitial fibrosis and acinar atrophy, obliterated phlebitis of the pancreatic veins, and involvement of the portal vein. Immunohistochemically, diffusely infiltrating cells consisted predominantly of CD4 or CD8 positive T lymphocytes and IgG4 positive plasma cells. Similar inflammatory processes also involved the peripancreatic tissue, extrahepatic bile duct, gall bladder, and salivary gland. Lymph nodes were swollen with infiltration of IgG4 positive plasma cells. None of these findings was seen in alcoholic chronic pancreatitis or Sjögren’s syndrome. Conclusions: The development of the specific inflammations in extensive organs as well as the pancreas in patients with autoimmune pancreatitis strongly suggests a close relationship between autoimmune pancreatitis and multifocal fibrosclerosis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Gut British Medical Journal

Close relationship between autoimmune pancreatitis and multifocal fibrosclerosis

Download PDF
5 pages

Loading next page...
 
/lp/british-medical-journal/close-relationship-between-autoimmune-pancreatitis-and-multifocal-qXqISLccFx

References (0)

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

Publisher
British Medical Journal
Copyright
Copyright 2003 by Gut
ISSN
0017-5749
eISSN
1468-3288
DOI
10.1136/gut.52.5.683
Publisher site
See Article on Publisher Site

Abstract

Background: Autoimmune pancreatitis is a unique clinical entity proposed recently, and is sometimes associated with inflammation of other organs. Aims: To examine the pathophysiology of the pancreas and other organs in patients with autoimmune pancreatitis. Patients and methods: We evaluated clinicopathological findings in six resected and one autopsied patient with autoimmune pancreatitis. The pancreas, peripancreatic tissue, bile duct, and gall bladder were examined histologically and immunohistochemically. Biopsied salivary gland and cervical lymph node of one patient were also examined. We also performed similar immunohistochemical examinations in pancreatectomy specimens from 10 patients with alcoholic chronic pancreatitis and biopsied salivary glands from five patients with Sjögren’s syndrome. Results: Stenosis of the extrahepatic bile duct was detected in all patients. Histological findings were characterised by diffuse lymphoplasmacytic infiltration with marked interstitial fibrosis and acinar atrophy, obliterated phlebitis of the pancreatic veins, and involvement of the portal vein. Immunohistochemically, diffusely infiltrating cells consisted predominantly of CD4 or CD8 positive T lymphocytes and IgG4 positive plasma cells. Similar inflammatory processes also involved the peripancreatic tissue, extrahepatic bile duct, gall bladder, and salivary gland. Lymph nodes were swollen with infiltration of IgG4 positive plasma cells. None of these findings was seen in alcoholic chronic pancreatitis or Sjögren’s syndrome. Conclusions: The development of the specific inflammations in extensive organs as well as the pancreas in patients with autoimmune pancreatitis strongly suggests a close relationship between autoimmune pancreatitis and multifocal fibrosclerosis.

Journal

Gut – British Medical Journal

Published: May 1, 2003

Keywords: autoimmune pancreatitis; multifocal fibrosclerosis; chronic pancreatitis; IgG4; plasma cell; ERCP, endoscopic retrograde cholangiopancreatography; hpf, high power field

There are no references for this article.