Original articles—liver, pancreas, and biliary tractA Diagnostic Strategy to Distinguish Autoimmune Pancreatitis From Pancreatic Cancer
Section snippets
Methods
The study was approved by Mayo Foundation Institutional Review Board.
Comparison of Demographics and Clinical Presentation
AIP patients were younger (mean age, 61 ± 16 vs 67 ± 12 years, P = .006) and more likely to be male (85% vs 57%, P < .001) compared with PaC patients. AIP patients presented with obstructive jaundice more often than PaC patients (87.5% vs 49%, P < .001). However, a similar proportion of AIP and PaC patients had abdominal pain (58% vs 50%), severe abdominal pain (15% vs 10%), back pain (10% vs 6.4%), weight loss of >10 pounds (51% vs 42%), and anorexia (30% vs 21%).
Pancreatic Findings on Computed Tomography Scan
A number of pancreatic
Discussion
In this comparative study of a large number of AIP and PaC patients, we found that CT features can stratify patients into groups that are highly likely to have AIP, those highly likely to have PaC, and those in whom the diagnosis is uncertain. Collateral evidence of AIP in the form of serum IgG4 elevation and other organ involvement can then help diagnose AIP in 70% of patients. However, ∼30% of AIP patients will require pancreatic core biopsy, steroid trial, or surgery to make the diagnosis.
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Conflicts of interest The authors disclose no conflicts.