Autoimmune Pancreatitis: Symptoms, Treatments & Tests

Autoimmune pancreatitis (AIP) is an autoimmune disorder, in which the body’s immune system attacks its own healthy cells. There are two types of AIP:

Type 1, which is more common, affects the pancreas and other organs in the body, including the liver and gallbladder.
Type 2 associated with inflammatory bowel disease.

Autoimmune Pancreatitis

How common is autoimmune pancreatitis?

AIP occurs in fewer than one in 100,000 people. It usually develops in people who are between the ages of 50 and 60, but can occur sooner. AIP affects men twice as often as women. The causes of AIP are not known.

SYMPTOMS AND CAUSES

What are the signs and symptoms of autoimmune pancreatitis?

The signs and symptoms of AIP are similar to pancreatic cancer, but AIP is not cancer.

AIP does not always cause symptoms. When it does, the main symptom is jaundice (yellowing of the skin and whites of the eyes). Other signs and symptoms can resemble symptoms of pancreatic cancer.

Symptoms of AIP include:

Mass or growth in the pancreas
Stomach pain
Weight loss
Back pain
Fatigue (extreme tiredness)

How is autoimmune pancreatitis diagnosed?

It is important to diagnose AIP correctly to rule out cancer and receive the right treatment. A doctor diagnoses AIP with several tests:

Blood tests can detect abnormal levels of a substance called serum IgG4, which can be a sign of AIP.
Imaging tests include:
- Ultrasound and computed axial tomography scan (CAT scan), which can produce images of the pancreas so that abnormalities may be seen;
- Esophagogastroduodenoscopy with ultrasound (images of the pancreas are obtained from inside the stomach and intestine using sound waves).
In some cases, doctors use a biopsy to rule out pancreatic cancer. In a biopsy, the doctor uses a small needle to remove a small amount of tissue from the pancreas for examination under a microscope.

To help make a definite diagnosis, your doctor may give you a trial dose of corticosteroids (medications that reduce inflammation). If the levels of serum IgG4 return to normal, it usually confirms the condition as AIP.

How is autoimmune pancreatitis managed or treated?

AIP is treated with corticosteroids to reduce inflammation. Treatment usually begins with a high dose of steroids, and then the dose is tapered down over time.

AIP doesn't usually require any other treatment. In some people, the disorder goes away without treatment. It is not uncommon for Type 1 AIP to relapse (return) when corticosteroid therapy stops. In that case, your doctor may recommend either another round of corticosteroid therapy or alternative steroid sparring strategies.

What complications are associated with autoimmune pancreatitis?

AIP sometimes occurs along with other autoimmune conditions such as rheumatoid arthritis and inflammatory bowel disease.

Can autoimmune pancreatitis be prevented?

Because the causes of AIP are not known, it cannot be prevented.

What is the prognosis (outlook) for people who have autoimmune pancreatitis?

AIP does not affect life expectancy. Some people need to continue steroid therapy for several years or for the rest of their lives to keep symptoms from returning. With successful management, people with the disorder can live active, healthy lives.