Pathology

Autoimmune Diseases Pancreatitis Chronic Diseases Treatment for Autoimmune Pancreatitis



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Autoimmune pancreatitis is an inflammation of the pancreas, the organ that aids in digestion. The pancreas is located near the stomach and small intestines and contains the Islets of Langerhans and Achinar cells. These two cells within the pancreas secrete hormones necessary for digestion. The Islets of Langerhans secrete the endocrines within the pancreas, which are then release glucagen and insulin. These two enzymes work together to regulate sugar levels. Achinar cells secrete exocrines into the duodenum, or small intestine, aiding the digestive function.

Any autoimmune disease means that the body is essentially attacking itself or the body’s tissues are attacked by its own immune system. Autoimmune pancreatitis is one of these diseases. Autoimmune Pancreatitis (AIP) may be difficult for doctors to diagnose, since it mimics other diseases, such as pancreatic cancer. But the basic signs of this disease include inflammation of the pancreas, attacks on the bile ducts, salivary glands, and lymph nodes.

Pancreatitis and autoimmune pancreatitis have similar symptoms. Because AIP is a chronic disease, the symptoms are less severe, but spread over a long period of time. Acute diseases have a sudden onset, but have more harsh symptoms, while chronic diseases have a slow onset with less severe symptoms. In the milder stages the patient experiences nausea, vomiting, and elevated pulse rate. Other symptoms less evident, until a doctor does a physical examination are swelling, tenderness, and pain. As AIP progresses symptoms progress to internal bleeding, dehydration, and low blood pressure.

If a doctor uses internal examinations, such as scans or imaging, additional symptoms that may be found are narrowing of the bile and pancreatic ducts, called stenosis. Lab tests show that the patient has higher blood sugar levels, plus another elevated level of serum gamma globulin, labeled IgG4. At this point, the patient’s body is essentially attacking itself.  They develop diabetes mellitus and rheumatoid arthritis. Jaundice, or yellowing of the skin and around the whites of the eyes, occurs in patients who have this disease. With the diseases progressive nature, the skin color darkens to brown.

What are AIP’s demographics? The age range can start as low as twelve years old into the thirties and forties. It typically target men twice as much as women. However, AIP can also be associated with or independent of other diseases such as rheumatoid arthritis, hypothyroidism (low thyroid function), inflammatory bowel disease (IBD), plus others.

Before receiving treatment, a thorough and accurate diagnosis is essential, since Autoimmune Pancreatitis can imitate the more serious pancreatic cancer, which requires surgery. While treatment for AIP was initially thought to respond to steroid shots, tests found that relapses were quite high in one study, almost 100%. A more common treatment is oral prednisone, which can be used for a second or third course. Patients responded to this treatment very well, over 70%. If a patient has pain, several options exist, including injections of non-steroidal anti-inflammatory drugs (NSAIDS). If patients want less expensive options, over-the-counter (OTC) treatments include (NSAIDS), such as ibuprofen or acetaminophen. If something stronger is required for pain, drugs such as codeine or opiates can be given to the patient. Treatments also include dietary changes, including balanced portions of fruits, vegetables, dairy meat, beans, grains, and healthy fats or oils, such as olive or vegetable oil.

Chronic autoimmune pancreatitis is a disease which can last from several weeks to several months. This painful disease requires careful diagnosis, since it can be mistaken for pancreatic cancer. Find a knowledgeable practitioner to correctly diagnose and treat the condition. Although treatment may occur of a long period of time, it will aid in relief from symptoms. 

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