Clinical Characteristics of 327 Asian Patients With Autoimmune Pancreatitis Based on Asian Diagnostic Criteria

Authors:
  • MKMyung-Hwan Kim
    Myung-Hwan Kim
  • QLQuanda Liu
    Quanda Liu
  • VBVallath Balakrishnan
    Vallath Balakrishnan
  • KOKazuichi Okazaki
    Kazuichi Okazaki
  • TSTooru Shimosegawa
    Tooru Shimosegawa
  • JCJae Bock Chung
    Jae Bock Chung
  • KLKyu Taek Lee
    Kyu Taek Lee
  • HWHsiu-Po Wang
    Hsiu-Po Wang
  • TLTsung-Chun Lee
    Tsung-Chun Lee
  • GCGourdas Choudhuri
    Gourdas Choudhuri
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Abstract
To clarify the clinical and pathophysiological characteristics of autoimmune pancreatitis (AIP) in Asia. A retrospective, actual situation survey of AIP diagnosed by Asian criteria was conducted in 10 centers of Japan, Korea, Taiwan, China, and India. A total of 327 AIP cases (258 male and 69 female subjects; average age, 60.0 years) were enrolled. Obstructive jaundice was the most frequent initial symptom (46%-74%), followed by weight loss (4%-51%) and abdominal pain (19%-44%). Diffuse swelling of the pancreas was frequent in Japan (64%) and Korea (81%), but segmental swelling of the pancreas was more frequent in Taiwan (70%) and China (72%) (P < 0.01). Serum immunoglobulin G4 levels were elevated in 58%-100% of cases in Japan, Korea, and Taiwan. Pathologically, almost all AIPs in Asia were lymphoplasmacytic sclerosing pancreatitis. Sclerosing cholangitis was the most frequent extrapancreatic lesion (60%-81%). Steroid therapy was a major and effective therapeutic strategy in Japan, Korea, and Taiwan. However, the rate of resection or bypass operation was higher in Taiwan (40%) and China (72%) (P < 0.01). Features of AIP are fundamentally similar in Japan, Korea, Taiwan, and China. Knowledge of emerging AIP should be more widespread in Asia to avoid unnecessary operation.

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