Autoimmune Pancreatitis | Digestive Health | Loyola Medicine

Autoimmune Pancreatitis

Overview and Facts about Autoimmune Pancreatitis

Autoimmune pancreatitis is a rare disease that is characterized by chronic or long-term inflammation of the pancreas. It affects an individual's digestive health because the pancreas functions intimately with the digestive system. Specifically, the pancreas is responsible for producing insulin, a protein that helps regulate the amount of sugar in your blood.

There are two types of autoimmune pancreatitis (type 1 and type 2). Type 1 is the most common form. Type 2 is distinct from type 1 in that type 2 is primarily confined to the pancreas, while type 1 can promote symptoms or disease inside and outside of the pancreas. Moreover, type 1 autoimmune pancreatitis is an IgG4-related disease with unique immune system causes, while type 2 autoimmune pancreatitis is not.

Signs and Symptoms of Autoimmune Pancreatitis

Many of the signs and symptoms of autoimmune pancreatitis mirror that of pancreatic cancer (cancer of the pancreas), so it is important to identify underlying causes of inflammation in the pancreas. Moreover, long-term effects of the disease are not well understood or known.

Pancreatitis can lead to a swollen or enlarged head of the pancreas or thicken the wall of the bile duct near the liver, which can lead to negative effects on digestive health, as bile flow from the liver is necessary for healthy digestion.

Individuals with autoimmune pancreatitis often experience the following:

  • An enlarged or abnormally-shaped and inflamed pancreas
  • Dark brown urine
  • Diabetic symptoms or signs of pancreatic failure, such as high and insulin-resistant blood sugar levels (specifically, type 2 diabetes mellitus)
  • Enlarged salivary glands
  • Jaundice or yellowing of the skin
  • Mild or moderate elevation of pancreas-derived enzymes in the blood
  • The presence or formation of stones in the pancreatic duct
  • Weight loss

Causes and Risk Factors of Autoimmune Pancreatitis

Individuals who are prone to inflammation or inflammatory diseases, such as lupus, are at risk of developing autoimmune pancreatitis. Moreover, type 1 autoimmune pancreatitis is more common in men over the age of 60.

Other risk factors include:

  • Alcohol abuse
  • Genetics or family history of autoimmune pancreatitis
  • H. pylori infection in individuals with a family history of autoimmune pancreatitis

Tests and Diagnosis of Autoimmune Pancreatitis

Since it is often difficult to differentiate autoimmune pancreatitis from pancreatic cancer, x-rays, computerized axial tomography (CAT) scans, and magnetic resonance imaging (MRI) are often used to examine pancreatic tissue. Small tissue samples from the pancreas may also be removed and examined under a microscope. Blood tests are also performed to look for signs of pancreatic failure, as well as inflammation.

Treatment and Care for Autoimmune Pancreatitis

Individuals with autoimmune pancreatitis may receive steroid treatment or immunosuppression therapy (therapy used to lower the immune system’s defenses) to help reduce inflammation. However, as the disease tends to recur in 15–60% of cases, it is unknown whether or not steroid treatment is effective in recurrent cases. Steroid treatment is not recommended in older patients with diabetes. In some cases, surgery may be required to remove diseased or damaged tissue from the pancreas.