Optimising corticosteroid treatment for autoimmune pancreatitis

Abstract

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.