Autoimmune pancreatitis is a rare autoimmune disease. In such a situation, the body’s immune system attacks its own healthy cells. This disease can usually be treated with steroid therapy. You can find more information below.
What is autoimmune pancreatitis?
Autoimmune pancreatitis is a chronic inflammation caused by the body’s immune system attacking the pancreas. There are two types, type 1 and type 2.
Type 1 is often part of the disease that affects many organs, including the pancreas, bile ducts in the liver, salivary glands, kidneys, and lymph nodes.
Type 2 , also called idiopathic duct-centered pancreatitis , only seems to affect the pancreas, but about one-third of people with type 2 have inflammatory bowel disease .
This disease is a rare, newly recognized disease and may be mistakenly diagnosed as pancreatic cancer. The two conditions have similar symptoms, but their treatments are very different. Therefore, it is very important to distinguish between the two.
What causes autoimmune pancreatitis?
Doctors don’t know what causes autoimmune pancreatitis, but as with other autoimmune diseases , the body’s immune system attacks healthy body tissues.
Who is at risk?
Both types of this disease occur with different frequencies in different parts of the world. For example, about 80 percent of people with autoimmune pancreatitis in the United States have the type 1.
People with type 1 autoimmune pancreatitis:
- is over 60 years old
- Usually male
People with type 2 autoimmune pancreatitis:
- Usually over 40 years old
- Men and women are equally affected
- More likely to have inflammatory bowel disease such as ulcerative colitis
What are the symptoms of autoimmune pancreatitis?
It is difficult to diagnose this disease. Usually, it does not cause any symptoms. When symptoms do appear, they are often the same as pancreatic cancer.
Symptoms may include:
- dark urine
- pale colored stool
- Yellow skin and eyes (jaundice)
- Pain in your upper abdomen or middle of your back
- Nausea and vomiting
- Weakness or extreme tiredness
- Loss of appetite or a feeling of fullness
- Weight loss for no known reason
The most common sign of autoimmune pancreatitis in about 80 percent of people is painless jaundice caused by blocked bile ducts. This disease can also cause weight loss.
When should you see a doctor?
This disease often does not cause symptoms. However, you should consult your doctor if you experience unexplained weight loss, abdominal pain , jaundice, or other signs and symptoms that bother you.
How is autoimmune pancreatitis diagnosed?
This condition is a difficult disease to diagnose because its signs and symptoms are the same as pancreatic cancer. However, a definitive diagnosis is extremely important. Undiagnosed cancer can result in delayed or not performing necessary surgical procedures.
People with this disease tend to have a general enlargement of the pancreas, but a mass may also be found in the pancreas. Blood and imaging tests are necessary to pinpoint the diagnosis and determine which type of this disease you have.
Specific tests may include:
Tests of your pancreas and other organs may include a computed tomography scan, magnetic resonance imaging , endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography.
Your blood will be tested for a high level of immunoglobulin called IgG4 produced by your immune system . People who have type 1 type of the disease but not type 2 will have high levels of IgG4.
But a positive test doesn’t necessarily mean you have the disease. A small number of people, some of whom have pancreatic cancer and do not have autoimmune pancreatitis, also have high IgG4 levels.
Endoscopic core biopsy
In this test, doctors analyze a sample of pancreatic tissue in the laboratory. Autoimmune pancreatitis has a distinctive appearance that is easily recognized under the microscope. Doctors insert a small tube (endoscope) from the mouth into the stomach and remove some tissue from the pancreas using a special needle guided by ultrasound.
The challenge is to obtain a tissue sample large enough to be analyzed instead of just a few cells. This procedure is not widely used and results may not be conclusive.
Because autoimmune pancreatitis is the only pancreatic disorder known to respond to steroids, doctors may sometimes want to try steroids to confirm the diagnosis. Response to corticosteroids is measured by computed tomography scan and values in serum IgG4 levels.
How is autoimmune pancreatitis treated?
Some treatments for this disease are listed under the following headings:
Biliary stent application
Before starting medication, sometimes doctors will insert a tube to drain the bile ducts in people with obstructive jaundice symptoms. Sometimes drainage is recommended if the diagnosis is uncertain.
Autoimmune pancreatitis symptoms usually improve after a short course of steroid medication. Many people respond surprisingly quickly and positively. Sometimes people get better without any treatment.
Immunosuppressants and immunomodulators
To help reduce the serious side effects associated with prolonged steroid use, doctors often add these immunosuppressant or altering drugs, sometimes called steroid sparing drugs, to treatment.
Pancreatic insufficiency treatment
If you have insufficient pancreatic enzymes, you may need additional enzymes. If you need supplements, your doctor will prescribe pancreatic enzymes.
If you have diabetes , you will need appropriate treatment. Your doctor will make the necessary directions.
Monitoring of other organ involvement
Type 1 autoimmune pancreatitis is often associated with other organ involvement, including enlarged lymph nodes and salivary glands, scarring of the bile ducts, liver inflammation, and kidney disease. Although these symptoms may completely decrease or disappear with steroid treatment, your doctor will continue to monitor you.
Complications of autoimmune pancreatitis
This disease can cause various complications.
- Pancreatic insufficiency: The disease can affect your pancreas’s ability to make enough enzymes. Signs and symptoms may include diarrhea, weight loss, metabolic bone disease, and vitamin or mineral deficiency.
- Diabetes: Because the pancreas is the organ that produces insulin, its damage can cause diabetes and you may need treatment with oral medication or insulin.
Like long-term steroid use, treatment for autoimmune pancreatitis can cause complications. However, even with these complications, people who receive treatment have a normal life expectancy.
Also, there is no definite relationship between autoimmune pancreatitis and pancreatic cancer.