LEADING ARTICLE Autoimmune related pancreatitis

Since the first documented case of a particular form of pancreatitis with hypergammaglobulinaemia, similar cases have been reported, leading to the concept of an autoimmune related pancreatitis or so-called “autoimmune pancreatitis”. Although it has not yet been widely accepted as a new clinical entity, the present article discusses the recent concept of autoimmune pancreatitis. SUMMARY Since Sarles et al reported a case of particular pancreatitis with hypergammaglobulinaemia, similar cases have been noted, which has led to the concept of an autoimmune related pancreati-tis or so-called “autoimmune pancreatitis”. The clinical characteristics are: (i) increased levels of serum gammaglobulin or IgG; (ii) presence of autoantibodies; (iii) diffuse enlargement of the pancreas; (iv) diffusely irregular narrowing im-ages of the main pancreatic duct; (v) fibrotic changes with lymphocyte infiltration; (vi) no or only mild symptoms; (vii) rare pancreatic calcifi-cation or pancreatic cysts; (viii) occasional associ-ation with other autoimmune diseases; and (ix) effective steroid therapy. In addition to various systemic autoimmune diseases, diabetes mellitus or bile duct lesions responsive to steroid therapy are often observed. Further studies are needed to clarify the pathogenesis