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Japanese consensus guidelines for management of autoimmune pancreatitis: II. Extrapancreatic lesions, differential diagnosis

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References

  1. Kamisawa T, Funata N, Hayashi Y, et al. Close relationship between autoimmune pancreatitis and multifocal fibrosclerosis. Gut. 2003;52:683–7.

    Article  CAS  PubMed  Google Scholar 

  2. Saegusa H, Momose M, Kawa S, et al. Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis. Pancreas. 2003;27:20–5.

    Article  PubMed  Google Scholar 

  3. Erkelens GW, Vleggaar FP, Lesterhuis W, et al. Sclerosing pancreato-cholangitis responsive to steroid therapy. Lancet. 1999;354:43–4.

    Article  CAS  PubMed  Google Scholar 

  4. Nakazawa T, Ohara H, Yamada T, et al. Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis. Hepatogastroenterology. 2001;48:625–30.

    CAS  PubMed  Google Scholar 

  5. Hamano H, Kawa S, Ochi Y, et al. Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis. Lancet. 2002;359:1403–4.

    Article  PubMed  Google Scholar 

  6. Takeda S, Haratake J, Kasai T, et al. IgG4-associated idiopathic tubulointerstitial nephritis complicating autoimmune pancreatitis. Nephrol Dial Transplant. 2004;19:474–6.

    Article  PubMed  Google Scholar 

  7. van der Vliet HJ, Perenboom RM. Multiple pseudotumors in IgG4-associated multifocal systemic fibrosis. Ann Intern Med. 2004;141:896–7.

    PubMed  Google Scholar 

  8. Komatsu K, Hamano H, Ochi Y, et al. High prevalence of hypothyroidism in patients with autoimmune pancreatitis. Dig Dis Sci. 2005;50:1052–7.

    Article  PubMed  Google Scholar 

  9. Yoshimura Y, Takeda S, Ieki Y, et al. IgG4-associated prostatitis complicating autoimmune pancreatitis. Intern Med. 2006;45:897–901.

    Article  PubMed  Google Scholar 

  10. Okazaki K, Uchida K, Matsushita M, et al. How to diagnose autoimmune pancreatitis by the revised Japanese clinical criteria. J Gastroenterol. 2007;42(Suppl 18):32–8.

    Article  PubMed  Google Scholar 

  11. Ohara H, Nakazawa T, Sano H, et al. Systemic extrapancreatic lesions associated with autoimmune pancreatitis. Pancreas. 2005;31:232–7.

    Article  PubMed  Google Scholar 

  12. Hamano H, Arakura N, Muraki T, et al. Prevalence and distribution of extrapancreatic lesions complicating autoimmune pancreatitis. J Gastroenterol. 2006;41:1197–205.

    Article  PubMed  Google Scholar 

  13. Kamisawa T, Egawa N, Inokuma S, et al. Pancreatic endocrine and exocrine function and salivary gland function in autoimmune pancreatitis before and after steroid therapy. Pancreas. 2003;27:235–8.

    Article  CAS  PubMed  Google Scholar 

  14. Yamamoto M, Ohara M, Suzuki C, et al. Elevated IgG4 concentrations in serum of patients with Mikulicz’s disease. Scand J Rheumatol. 2004;33:432–3.

    Article  CAS  PubMed  Google Scholar 

  15. Yamamoto M, Harada S, Ohara M, et al. Clinical and pathological differences between Mikulicz’s disease and Sjogren’s syndrome. Rheumatology (Oxford). 2005;44:227–34.

    Article  CAS  Google Scholar 

  16. Manoussakis M, Mouttsopoulos H. Sjoegren syndrome. 4th ed. St Louis: Academic Press; 2006.

    Google Scholar 

  17. Taniguchi T, Ko M, Seko S, et al. Interstitial pneumonia associated with autoimmune pancreatitis. Gut. 2004;53:770. (author reply 770–1).

    CAS  PubMed  Google Scholar 

  18. Hirano K, Kawabe T, Komatsu Y, et al. High-rate pulmonary involvement in autoimmune pancreatitis. Intern Med J. 2006;36:58–61.

    Article  CAS  PubMed  Google Scholar 

  19. Takato H, Yasui M, Ichikawa Y, et al. Nonspecific interstitial pneumonia with abundant IgG4-positive cells infiltration, which was thought as pulmonary involvement of IgG4-related autoimmune disease. Intern Med. 2008;47:291–4.

    Article  PubMed  Google Scholar 

  20. Hamed G, Tsushima K, Yasuo M, et al. Inflammatory lesions of the lung, submandibular gland, bile duct and prostate in a patient with IgG4-associated multifocal systemic fibrosclerosis. Respirology. 2007;12:455–7.

    Article  PubMed  Google Scholar 

  21. Zen Y, Kitagawa S, Minato H, et al. IgG4-positive plasma cells in inflammatory pseudotumor (plasma cell granuloma) of the lung. Hum Pathol. 2005;36:710–7.

    Article  CAS  PubMed  Google Scholar 

  22. Nakazawa T, Ohara H, Sano H, et al. Schematic classification of sclerosing cholangitis with autoimmune pancreatitis by cholangiography. Pancreas. 2006;32:229.

    Article  PubMed  Google Scholar 

  23. Nakazawa T, Ohara H, Sano H, et al. Clinical differences between primary sclerosing cholangitis and sclerosing cholangitis with autoimmune pancreatitis. Pancreas. 2005;30:20–5.

    PubMed  Google Scholar 

  24. Nishino T, Oyama H, Hashimoto E, et al. Clinicopathological differentiation between sclerosing cholangitis with autoimmune pancreatitis and primary sclerosing cholangitis. J Gastroenterol. 2007;42:550–9.

    Article  CAS  PubMed  Google Scholar 

  25. Ghazale A, Chari ST, Zhang L, et al. Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy. Gastroenterology. 2008;134:706–15.

    PubMed  Google Scholar 

  26. Nakazawa T, Ohara H, Sano H, et al. Cholangiography can discriminate sclerosing cholangitis with autoimmune pancreatitis from primary sclerosing cholangitis. Gastrointest Endosc. 2004;60:937–44.

    Article  PubMed  Google Scholar 

  27. Zen Y, Harada K, Sasaki M, et al. IgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis? Am J Surg Pathol. 2004;28:1193–203.

    Article  PubMed  Google Scholar 

  28. Aoki S, Nakazawa T, Ohara H, et al. Immunohistochemical study of autoimmune pancreatitis using anti-IgG4 antibody and patients’ sera. Histopathology. 2005;47:147–58.

    Article  CAS  PubMed  Google Scholar 

  29. Uehara T, Hamano H, Kawa S, et al. Distinct clinicopathological entity ‘autoimmune pancreatitis-associated sclerosing cholangitis’. Pathol Int. 2005;55:405–11.

    Article  PubMed  Google Scholar 

  30. Umemura T, Zen Y, Hamano H, et al. Immunoglobin G4-hepatopathy: association of immunoglobin G4-bearing plasma cells in liver with autoimmune pancreatitis. Hepatology. 2007;46:463–71.

    Article  CAS  PubMed  Google Scholar 

  31. Hamano H, Umemura T, Uehara T, et al. IgG4-related sclerosing cholangitis should be included as an exclusion criterion for the diagnosis of primary sclerosing cholangitis. Am J Gastroenterol. 2007;102:691–2.

    Article  PubMed  Google Scholar 

  32. Hayashi K, Nakazawa T, Ohara H, et al. Autoimmune sclerosing cholangiopancreatitis with little pancreatic involvements by imaging findings. Hepatogastroenterology. 2007;54:2146–51.

    PubMed  Google Scholar 

  33. Tamada K, Kanai N, Wada S. Utility and limitations of intraductal ultrasonography in distinguishing longitudinal cancer extension along the bile duct from inflammatory wall thickening. Abdom Imaging. 2001;26:623–31.

    Article  CAS  PubMed  Google Scholar 

  34. Kitajima Y, Ohara H, Nakazawa T. Usefulness of transpapillary bile duct brushing cytology and forceps biopsy for improved diagnosis in patients with biliary strictures. J Gastroenterol Hepatol. 2007;22:1615–20.

    Article  PubMed  Google Scholar 

  35. Hyodo N, Hyodo T. Ultrasonographic evaluation in patients with autoimmune-related pancreatitis. J Gastroenterol. 2003;38:1155–61.

    Article  PubMed  Google Scholar 

  36. Hyodo T, Hyodo N, Yamanaka T. Contrast-enhanced intraductal ultrasonography for thickened bile duct wall. J Gastroenterol. 2001;36:557–9.

    Article  CAS  PubMed  Google Scholar 

  37. Tamada K, Tomiyama T, Oohashi A, et al. Bile duct wall thickness measured by intraductal US in patients who have not undergone previous biliary drainage. Gastrointest Endosc. 1999;48:199–203.

    Article  Google Scholar 

  38. Abraham SC, Wilentz RE, Yeo CJ, et al. Pancreaticoduodenectomy (Whipple resections) in patients without malignancy: are they all ‘chronic pancreatitis’? Am J Surg Pathol. 2003;27:110–20.

    Article  PubMed  Google Scholar 

  39. Yoshida K, Toki F, Takeuchi T, et al. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis. Dig Dis Sci. 1995;40:1561–8.

    Article  CAS  PubMed  Google Scholar 

  40. Okazaki K, Chiba T. Autoimmune related pancreatitis. Gut. 2002;51:1–4.

    Article  CAS  PubMed  Google Scholar 

  41. Okazaki K, Kawa S, Kamisawa T, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006;41:626–31.

    Article  PubMed  Google Scholar 

  42. Hamano H, Kawa S, Horiuchi A, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med. 2001;344:732–8.

    Article  CAS  PubMed  Google Scholar 

  43. Kawa S, Hamano H, Kiyosawa K. Pancreatitis. 4th ed. St Louis: Academic Press; 2006.

    Google Scholar 

  44. Kawa S, Hamano H. Clinical features of autoimmune pancreatitis. J Gastroenterol. 2007;42(Suppl 18):9–14.

    Article  PubMed  Google Scholar 

  45. Ghazale A, Chari ST, Smyrk TC, et al. Value of serum IgG4 in the diagnosis of autoimmune pancreatitis and in distinguishing it from pancreatic cancer. Am J Gastroenterol. 2007;102:1646–53.

    Article  CAS  PubMed  Google Scholar 

  46. Choi EK, Kim MH, Lee TY, et al. The sensitivity and specificity of serum immunoglobulin G and immunoglobulin G4 levels in the diagnosis of autoimmune chronic pancreatitis: Korean experience. Pancreas. 2007;35:156–61.

    Article  PubMed  Google Scholar 

  47. Irie H, Honda H, Baba S, et al. Autoimmune pancreatitis: CT and MR characteristics. Am J Roentgenol. 1998;170:1323–7.

    CAS  Google Scholar 

  48. Takahashi N, Fletcher JG, Fidler JL, et al. Dual-phase CT of autoimmune pancreatitis: a multireader study. Am J Roentgenol. 2008;190:280–6.

    Article  Google Scholar 

  49. Kawamoto S, Siegelman SS, Hruban RH, et al. Lymphoplasmacytic sclerosing pancreatitis (autoimmune pancreatitis): evaluation with multidetector CT. Radiographics. 2008;28:157–70.

    Article  PubMed  Google Scholar 

  50. Ichikawa T, Sou H, Araki T. Duct-penetrating sign at MRCP: usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas. Radiology. 2001;221:107–16.

    Article  CAS  PubMed  Google Scholar 

  51. Takayama M, Hamano H, Ochi Y, et al. Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation. Am J Gastroenterol. 2004;99:932–7.

    Article  PubMed  Google Scholar 

  52. Farrell JJ, Garber J, Sahani D, et al. EUS findings in patients with autoimmune pancreatitis. Gastrointest Endosc. 2004;60:927–36.

    Article  PubMed  Google Scholar 

  53. Sahani DV, Kalva SP, Farrell J, et al. Autoimmune pancreatitis: imaging features. Radiology. 2004;233:345–52.

    Article  PubMed  Google Scholar 

  54. Kamisawa T, Egawa N, Nakajima H, et al. Clinical difficulties in the differentiation of autoimmune pancreatitis and pancreatic carcinoma. Am J Gastroenterol. 2003;98:2694–9.

    Article  PubMed  Google Scholar 

  55. Sahai A, Zimmerman M, Aabakken L, et al. Prospective assessment of the ability of endoscopic ultrasound to diagnose, exclude, or establish the severity of chronic pancreatitis found by endoscopic retrograde cholangiopancreatography. Gastrointest Endosc. 1998;48:18–25.

    Article  CAS  PubMed  Google Scholar 

  56. Rösch T, Lorenz R, Braig C, et al. Endoscopic ultrasound in pancreatic tumor diagnosis. Gastrointest Endosc. 1991;37:347–52.

    Article  PubMed  Google Scholar 

  57. Deshpande V, Mino-Kenudson M, Brugge WR, et al. Endoscopic ultrasound guided fine needle aspiration biopsy of autoimmune pancreatitis: diagnostic criteria and pitfalls. Am J Surg Pathol. 2005;29:1464–71.

    Article  PubMed  Google Scholar 

  58. Williams D, Sahai A, Aabakken L, et al. Endoscopic ultrasound guided fine-needle aspiration biopsy: a large single centre experience. GUT. 1999;44:720–6.

    Article  CAS  PubMed  Google Scholar 

  59. Eloubeidi M, Chen V, Eltoum I. Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer: diagnostic accuracy and acute and 30-day complications. Am J Gastroenterol. 2003;98:2663–8.

    PubMed  Google Scholar 

  60. Inoue H, Miyatani H, Sawada Y, et al. A case of pancreas cancer with autoimmune pancreatitis. Pancreas. 2006;33:208–9.

    Article  PubMed  Google Scholar 

  61. Witkiewicz AK, Kennedy EP, Kennyon L, et al. Synchronous autoimmune pancreatitis and infiltrating pancreatic ductal adenocarcinoma: case report and review of the literature. Hum Pathol. 2008;39:1548–51.

    Article  PubMed  Google Scholar 

  62. Deshpande V, Chicano S, Finkelberg D, et al. Autoimmune pancreatitis: a systemic immune complex mediated disease. Am J Surg Pathol. 2006;30:1537–45.

    Article  PubMed  Google Scholar 

  63. Zhang L, Notohara K, Levy MJ, et al. IgG4-positive plasma cell infiltration in the diagnosis of autoimmune pancreatitis. Mod Pathol. 2007;20:23–8.

    Article  CAS  PubMed  Google Scholar 

  64. Bang SJ, Kim MH, Kim do H, et al. Is pancreatic core biopsy sufficient to diagnose autoimmune chronic pancreatitis? Pancreas. 2008;36:84–9.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant-in-aid for Refractory Pancreatic Disease from the Ministry of Labor, Health, and Welfare of Japan.

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Correspondence to Shigeyuki Kawa.

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This article is the second of a three-article series on the Japanese consensus guidelines. Please see the first article in the series (doi:10.1007/s00535-009-0184-x) for the abstract, keywords, and names of committee members.

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Kawa, S., Okazaki, K., Kamisawa, T. et al. Japanese consensus guidelines for management of autoimmune pancreatitis: II. Extrapancreatic lesions, differential diagnosis. J Gastroenterol 45, 355–369 (2010). https://doi.org/10.1007/s00535-009-0197-5

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