Commentaries

Autoimmune pancreatitis

Optimising corticosteroid treatment for autoimmune pancreatitis

Amaar Ghazale, Suresh T Chari

Division of Gastroenterology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Correspondence to:
Suresh Chari, 200 First Street SW, Rochester, MN 55905, USA; chari.suresh@mayo.edu

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Unanswered questions

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The first 150 words of the full text of this article appear below.

Autoimmune pancreatitis (AIP) is part of a systemic fibro-inflammatory disease that can involve multiple organs which characteristically have a lymphoplasmacytic infiltrate rich in IgG4-positive cells. IgG4-related systemic disease (ISD) has been proposed by Kamisawa et al as the umbrella term to describe this multi-organ disease.¹ Although the fibrosis in ISD can often lead to damage and even destruction of the involved organ, the inflammatory process typically responds to steroid treatment. However, the resolution of the inflammatory process in ISD may occur spontaneously without steroid treatment, especially in AIP.^{2 3} The effect of steroid treatment on the natural history of AIP is not known as it is only recently that large series of AIP are being reported.

In this issue of Gut (page 1719), Hirano et al⁴ report the results of a retrospective review of 42 AIP patients of whom 19 were treated with steroids. The authors’ goal . . . [Full text of this article]

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