IgG4相关性胰腺炎的诊断与治疗

Diagnosis and treatment of IgG4-related pancreatitis

  • 摘要: IgG4相关性胰腺炎即I型自身免疫性胰腺炎,是IgG4相关性疾病累及胰腺的表现。IgG4相关性胰腺炎常因其临床表现与胰腺癌相似而误诊,病理学及影像学检查是诊断该病的重要依据。目前,IgG4相关性胰腺炎治疗的主要手段为糖皮质激素,但在药物减量或撤药之后复发率高。笔者结合相关文献及临床经验,对IgG4相关性胰腺炎发病机制、临床表现、临床诊断、与胰腺癌的鉴别、临床治疗方面进行分析总结,认为对于其发病机制的进一步阐明及在此基础之上采取针对性的免疫疗法可能是改善其疗效的方向之一。

     

    Abstract: Immunoglobulin G (IgG)4-related pancreatitis, also named as type Ⅰ autoimmune pancreatitis, is recognized as a pancreatic manifestation of IgG4-related disease. It is very hard to differentiate it from pancreatic cancer due to similar clinical manifestations with pancreatic cancer. Diagnosis of IgG4-related pancreatitis mainly relies on pathological examination and imaging examination. Corticosteroids are the main treatment for IgG4-related pancreatitis, and the risk of relapse is still high with steroid taper or following withdrawal of steroids. Based on researches on IgG4-related pancreatitis and our clinical experience, the authors have analyzed and summarized pathogenesis, clinical manifestations, clinical diagnosis, differentiation from pancreatic cancer, clinical treatment of IgG4-related pancreatitis, and suggested that elucidation of its mechanism and induction of immunotherapy may improve its efficacy.

     

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