Abstract
AimsTo provide comprehensive data on the diagnosis and treatment of autoimmune pancreatitis (AIP) patients in China.DesignA systematic review.MethodsAll clinical studies concerning AIP from China published between January 2006 and June 2014 were retrospectively reviewed and analyzed.ResultsA total of 26 original articles involving 706 AIP patients were included with an estimated proportion of type 2 AIP as 4.7%. In the 706 AIP patients, the range of mean/median age was 48.6–67.0 years old and the male to female ratio was 4.47:1. The common presentations included obstructive jaundice (pooled rate: 63.4%, 95%CI: 55.4%–71.0%) and abdominal symptoms (pooled rate: 62.3%, 95%CI: 52.4%–71.7%). Biliary involvement was the most common extrapancreatic manifestations, especially the lower part of the common bile duct (pooled rate: 62.3%, 95%CI: 49.9%–73.9%). According to the imaging examinations, 53.8% and 41.6% patients were classified into focal-type and diffuse-type, respectively. Notably, upstream pancreatic duct dilatation was found in parts of patients (pooled rate: 13.8%, 95%CI: 6.6%–23.1%). The levels of serum IgG4 were elevated in most patients (pooled rate: 86.0%, 95%CI: 74.2%–94.6%). Nearly three tenths AIP patients received surgery (pooled rate: 29.7%, 95%CI: 18.1%–42.8%) due to mimicked malignancy. Steroid treatment was given to 78.4% patients (95%CI: 65.3%–89.1%) with a pooled remission rate of 96.2% (95%CI: 94.0%–97.9%). The pooled relapse rate was 13.8% (95%CI: 7.2%–22.0%) with the mean follow-up time ranging from 12 to 45 months.ConclusionType 1 is the predominant type of Chinese AIP patients and the clinical features, diagnostic modalities and therapeutic regimen were similar with those in other countries. Knowledge of AIP should be more widespread to avoid unnecessary surgery.
Highlights
Since it was first reported in 1961 by Sarles et al [1] and was termed as autoimmune pancreatitis (AIP) in 1995 by Yoshida et al [2], AIP has gradually attracted attention in recent years
Diagnostic criteria of AIP have been proposed in Japan, United States, Korea and Italy, and an International Consensus Diagnostic Criteria (ICDC) for AIP has been reached [4]
It has been nearly two decades since Yoshida et al proposed the term autoimmune pancreatitis in 1995 [2] and AIP has become a focus in research
Summary
Since it was first reported in 1961 by Sarles et al [1] and was termed as autoimmune pancreatitis (AIP) in 1995 by Yoshida et al [2], AIP has gradually attracted attention in recent years. Diagnostic criteria of AIP have been proposed in Japan, United States, Korea and Italy, and an International Consensus Diagnostic Criteria (ICDC) for AIP has been reached [4]. China has a high prevalence of pancreatic disease [5], and if the prevalence rate of AIP in Japan (2.2 per 100,000 populations) was used, the estimated amount of AIP patients would be 29 thousand [6]. We collected all well-designed clinical studies of AIP from China, and provided comprehensive data on the clinical presentation, diagnosis and treatment of Chinese AIP patients
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