Preventing disease relapses in autoimmune pancreatitis with maintenance steroids: are we there yet?

Autoimmune pancreatitis (AIP) is a fibro-inflammatory disease, which has defining histopathology and is characterised by a dramatic response to steroid treatment.1 Type 1 AIP describes the pancreatic manifestation of a multiorgan syndrome, currently referred to as IgG4-related disease and is frequently associated with an elevated serum IgG4 antibody level.2 This is a chronic disease with relapses occurring in 30–50% of patients within 3 years of disease onset.3 4 Published data suggest that low-dose maintenance steroids may decrease the risk for future disease relapse; however, this has not been demonstrated in a prospective clinical trial.5 In the present study, Masamune et al6 present their findings from a randomised controlled trial (RCT) examining the efficacy of low-dose steroids for maintenance of disease remission. We discuss this article in the context of the existing literature and identify future opportunities to improve...
Source: Gut - Category: Gastroenterology Authors: Tags: Commentary Source Type: research

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​Paracentesis can be a quick and simple procedure with the right equipment and a well-rehearsed approach. It's important to practice this skill in the procedure lab and to familiarize yourself with the kit in your department a few times a year. This month, we focus on paracentesis set-up and basics, and next month we will review the nuts and bolts of completing the procedure.Important equipment for paracentesis: Five or six collection bottles, antiseptic prep, and a paracentesis kit. Consider longer needles for abdominal walls thicker than 2.5 cm.Grab the ultrasound and a pen. Position your patient at a 45-degree angle, ...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Autoimmune pancreatitis (AIP) is a relatively newly discovered and rare disease that can be challenging to recognize and diagnose.1 Although a case report first described it in 1961, not until 1995 did it begin to be recognized as a clinical entity in a case series by Yoshida et  al.2 Type 1 AIP is the most common worldwide and is associated with IgG4-positive cells and histologic features described as lymphocytoplasmic sclerosing pancreatitis (LPSP) without granulocyte epithelial lesions, which are seen in type 2 AIP.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Immunotherapy has transformed the treatment landscape for a wide range of human cancers. Immune checkpoint inhibitors (ICIs), monoclonal antibodies that block the immune-regulatory “checkpoint” receptors CTLA-4, PD-1, or its ligand PD-L1, can produce durable responses in some patients. However, coupled with their success, these treatments commonly evoke a wide range of immune-related adverse events (irAEs) that can affect any organ system and can be treatment-limiting and life-threatening, such as diabetic ketoacidosis, which appears to be more frequent than initially described. The majority of irAEs from check...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
In this study, we aimed to analyze the genetic risk factors in children with IARP.MethodsAll children (
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
CONCLUSIONS: At adolescence, both Crohn's disease and ulcerative colitis are associated with multiple comorbidities, not limited to autoimmune disorders. PMID: 31801156 [PubMed - as supplied by publisher]
Source: Pediatric Research - Category: Pediatrics Authors: Tags: Pediatr Res Source Type: research
CONCLUSIONS: Fecal elastase-1 level was normal in all patients with CD strongly indicated absence of PEI in this group of patients. PMID: 31760738 [PubMed - as supplied by publisher]
Source: Minerva Gastroenterologica e Dietologica - Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research
AbstractDipeptidyl peptidase (DPP) ‐4 inhibitors, a class of oral hypoglycemic agents, are widely used, especially in Asian populations, as they have been shown to be well‐tolerated and to cause relatively few hypoglycemic events despite exerting a potent glucose‐lowering effect by promoting endogenous insulin secretion, beside s also having extra‐pancreatic effects. Meanwhile, use of DPP‐4 inhibitors has been reported to be associated with the development of bullous pemphigoid (BP), a rare autoimmune blistering skin disease1, even though the absolute increase in the risk of development of BP is relatively low.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: Commentary Source Type: research
Publication date: November 2019Source: Human Pathology: Case Reports, Volume 18Author(s): Kevin Gowing, David F. Schaeffer, Hui-Min YangAbstractMucinous cystic neoplasm (MCN) is characterized by mucinous epithelial lining and subepithelial ovarian-like stroma and is a precursor to invasive carcinoma. Type 1 autoimmune pancreatitis (AIP), on the other hand, is a form of IgG4-related disease (IgG4-RD) and can present as a pancreatic mass. There is no known causal relationship between these two entities in the current literature. Here, we report a case of a middle-aged female patient who was found to have an enlarging pancrea...
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research
This study lists the various anomalies on the basis of 504 references selected from a PubMed search in October 2018. RESULTS: The anomalies are grouped into three categories: anatomical anomalies: duodenal atresia and stenosis (3.9%), duodenal web and annular pancreas; aberrant right subclavian artery (12% of children with DS with cardiac anomaly); Hirschsprung's disease (2.76%); anorectal malformation (1.16%); congenital vascular malformations of the liver; orofacial cleft, bifid uvula (4.63%), and submucous orofacial cleft; esophageal atresia (0.5-0.9%); pyloric stenosis (0.3%); diaphragmatic hernia; malrotation of ...
Source: Archives de Pediatrie - Category: Pediatrics Authors: Tags: Arch Pediatr Source Type: research
Conclusions: The predictive value of FiCE for pancreatic cancer prevalence was 47%. Histological confirmation with pancreatic juice cytology is necessary before surgical resection. PMID: 31744269 [PubMed - as supplied by publisher]
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
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