The role of serological biomarkers in the diagnosis and management of autoimmune pancreatitis. (2nd November 2022)

• Record Type: Journal Article
• Authors: de Pretis, Nicolò; Amodio, Antonio; De Marchi, Giulia; Marconato, Eugenio; Ciccocioppo, Rachele; Frulloni, Luca
• Is Part Of: Expert review of clinical immunology. Volume 18:Number 11(2022)
• Page Start: 1119
• Page End: 1124
• Publication Date: 2022-11-02
• Subjects: IgG4-related disease -- autoimmune pancreatitis -- IgG4 -- diagnosis; Clinical immunology -- Periodicals; 616.079
• DOI: 10.1080/1744666X.2022.2125379
• Languages: English
• ISSNs: 1744-666X

Abstract

ABSTRACT: Introduction: Autoimmune pancreatitis (AIP) is a fibroinflammatory disease of the pancreas. Type 1 AIP is the pancreatic manifestation of a systemic IgG4-related disease and is associated with serum elevation of IgG4, tissue infiltration of IgG4-positive plasma cells, and multiorgan involvement. Although serum IgG4 elevation is considered a useful diagnostic tool, the concomitant presence of more diagnostic criteria is needed to achieve diagnosis. No other biomarkers have been approved in clinical practice in type 1 AIP. Type 2 AIP is a pancreatic-specific disease associated with inflammatory bowel disease. No specific biomarkers for type 2 AIP have been identified. Areas covered: The role of serum IgG4 in the diagnosis, management and follow-up of patients with type 1 AIP. Moreover, data on other emerging biomarkers for type 1 and 2 AIP have been reported. Expert Opinion: The diagnosis of AIP is challenging in clinical practice, especially for focal forms without multiorgan involvement, where distinction from pancreatic cancer can be difficult. Despite the strong association with type 1 AIP, serum IgG4 should only be measured when the suspicion for the disease is high, considering its limited sensitivity. New biomarkers with high diagnostic yield for both type 1 and type 2 AIP are needed.