Faculty Collaboration Database

Demystifying seronegative autoimmune pancreatitis. Pancreatology 2012;12(4):289-94

Date

08/18/2012

Pubmed ID

22898628

DOI

10.1016/j.pan.2012.05.003

Scopus ID

2-s2.0-84866511544 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

BACKGROUND: Autoimmune pancreatitis (AIP) has been classified into type 1 and type 2 subtypes. Serum immunoglobulin G4 (IgG4) elevation characterizes type 1 AIP. Type 2 AIP and a subset of type 1 AIP are seronegative, i.e., have normal serum IgG4 levels.

AIM: We compared the profiles of the three subsets of AIP to identify the unique characteristics of seronegative type 1 AIP and type 2 AIP.

METHODS: We compared the clinical profiles of 69 seropositive type 1 AIP patients, 21 seronegative type 1 AIP patients and 22 type 2 AIP patients.

RESULTS: Among type 1 AIP, seronegative group had similar clinical profiles when compared to seropositive group except that they were more likely to undergo surgical resection than seropositive patients (p = 0.001). Seronegative type I AIP patients were older (61.9 ± 13.7 vs 45.3 ± 17.4; p = 0.004), and differed in the occurrence of other organ involvement (OOI) (71.4% vs 0%; p < 0.001) and disease relapse (33.3% vs 0%; p = 0.005) when compared with type 2 AIP. All seronegative type 1 AIP patients had at least one of the following -OOI, disease relapse, and age >50 years while none of the type 2 AIP had OOI or disease relapse.

CONCLUSIONS: Seronegative and seropositive type 1 AIP patients have similar clinical profiles, which are distinct from that of type 2 AIP. Among the seronegative AIP group, patients are more likely to have type 1 AIP rather than type 2 AIP if they are older than 50 years or have OOI or disease relapse.

Author List

Balasubramanian G, Sugumar A, Smyrk TC, Takahashi N, Clain JE, Gleeson FC, Hart PA, Levy MJ, Pearson RK, Petersen BT, Topazian MD, Vege SS, Chari ST

Author

Gokulakrishnan Balasubramanian MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Autoimmune Diseases
Female
Humans
Immunoglobulin G
Male
Middle Aged
Pancreas
Pancreatitis
Plasma Cells
Prednisone
Recurrence