Diagnosing autoimmune pancreatitis with the Unifying-Autoimmune-Pancreatitis-Criteria
Background/Objectives: We had developed the Unifying-Autoimmune-Pancreatitis-Criteria (U-AIP) to diagnose autoimmune pancreatitis (AiP) within the M-ANNHEIM classification of chronic pancreatitis. In 2011, International-Consensus-Diagnostic-Criteria (ICDC) to diagnose AiP have been published. We had...
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| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2017
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| In: |
Pancreatology
Year: 2017, Volume: 17, Issue: 3, Pages: 381-394 |
| ISSN: | 1424-3911 |
| DOI: | 10.1016/j.pan.2017.03.005 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1016/j.pan.2017.03.005 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S1424390317300601 
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| Author Notes: | Alexander Schneider, Henrik Michaely, Felix Rückert, Christel Weiss, Philipp Ströbel, Sebastian Belle, Michael Hirth, Torsten J. Wilhelm, Stephan L. Haas, Ralf Jesenofsky, Stefan Schönberg, Alexander Marx, Manfred V. Singer, Matthias P. Ebert, Roland H. Pfützer, J. Matthias Löhr |
| Summary: | Background/Objectives: We had developed the Unifying-Autoimmune-Pancreatitis-Criteria (U-AIP) to diagnose autoimmune pancreatitis (AiP) within the M-ANNHEIM classification of chronic pancreatitis. In 2011, International-Consensus-Diagnostic-Criteria (ICDC) to diagnose AiP have been published. We had applied the U-AIP long before the ICDC were available. The aims of the study were, first, to describe patients with AiP diagnosed by the U-AIP; second, to compare diagnostic accuracies of the U-AIP and other diagnostic systems; third, to evaluate the clinical applicability of the U-AIP. Methods: From 1998 until 2008, we identified patients with AiP using U-AIP, Japanese-, Korean-, Asian-, Mayo-HISORt-, Revised-Mayo-HISORt- and Italian-criteria. We retrospectively verified the diagnosis by ICDC and Revised-Japanese-2011-criteria, compared diagnostic accuracies of all systems and evaluated all criteria in consecutive patients with pancreatitis (2009 until 2010, Pancreas-Outpatient-Clinic-Cohort, n = 84). We retrospectively validated our diagnostic approach in consecutive patients with a pancreatic lesion requiring surgery (Surgical-Cohort, n = 98). Results: Overall, we identified 21 patients with AiP. Unifying-Autoimmune-Pancreatitis-Criteria and ICDC presented the highest diagnostic accuracies (each 98.8%), highest Youden indices (each 0.95238), and highest proportions of diagnosed patients (each n = 20/21, U-AIP/ICDC vs. other diagnostic systems, p < 0.05, McNemar test). In the Pancreas-Outpatient-Clinic-Cohort, seven patients were diagnosed with AiP (n = 6 by U-AIP, n = 1 by Asian-criteria). International-Consensus-Diagnostic-Criteria confirmed the diagnosis in these individuals. Based on partial fulfillment of U-AIP, AiP was initially suspected in 13% (n = 10/77) of remaining patients from the Pancreas-Outpatient-Clinic-Cohort. In the Surgical-cohort, we identified one patient with AiP by U-AIP and ICDC. Conclusions: Unifying-Autoimmune-Pancreatitis-Criteria revealed a satisfactory clinical applicability and offered an additional approach to diagnose AiP. |
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| Item Description: | Available online 18 March 2017 Gesehen am 19.06.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1424-3911 |
| DOI: | 10.1016/j.pan.2017.03.005 |