Steroid-responsive pancreatitides

World J Clin Cases. 2020 Aug 26;8(16):3411-3430. doi: 10.12998/wjcc.v8.i16.3411.

Abstract

Autoimmune pancreatitis has received considerable attention, especially due to the marked effect of corticosteroid therapy on its clinical course. Knowledge, especially regarding type 1 autoimmune pancreatitis, has significantly increased over the last decades, and despite significant differences in pathophysiology and outcomes, both type 1 and 2 autoimmune pancreatitis are still considered different types of the same disease. Some have proposed a different nomenclature reflecting these differences. Although the term steroid-responsive pancreatitides may be interpreted as synonymous to type 1 and 2 autoimmune pancreatitis, these are not the only pancreatic conditions that show a response to steroid therapy. Acute pancreatitis caused by vasculitis and connective tissue diseases and acute pancreatitis secondary to checkpoint inhibitors or programmed cell death receptor antibody-mediated blockage cancer therapy may also benefit from steroid treatment. This review presents current concepts on these disorders, aiming to increase awareness, analyze similarities and differences, and propose a new nomenclature that reflects their specific particularities, clustering them under the term "steroid-responsive pancreatitides".

Keywords: Autoimmune pancreatitis; Corticosteroids; Idiopathic duct centric chronic pancreatitis; Immune checkpoint inhibitors; Lymphoplasmacytic sclerosing pancreatitis; Vasculitis.

Publication types

  • Review