Supplementary Material for: Idiopathic Duct-Centric Pancreatitis: Disease Description and Endoscopic Ultrasonography-Guided Trucut Biopsy Diagnosis
2017
Background/Aims: Recent data demonstrate the presence of two
autoimmune pancreatitis (AIP) subtypes. All existing endoscopic
ultrasonography-guided trucut biopsy (EUS-TCB) data pertain to type 1
disease. Our aim is to determine if EUS-TCB samples are sufficient for
diagnosing type 2 AIP. Methods: This is a retrospective case
series conducted in an academic tertiary care center. Patients included
those with type 2 AIP (n = 5), retrospectively identified from a
database of all patients with AIP, diagnosed by HISORt criteria (n =
125). The primary outcome measure was the diagnostic capability of
EUS-TCB for type 2 AIP. Results: 5 patients (4 male, 1 female; mean age 39.6 years) who underwent EUS-TCB were diagnosed with type 2 AIP. The serum IgG 4 level was elevated in 1 of the 4 patients tested. CT/MRI revealed
diffuse pancreas enlargement (n = 3), a pancreas head mass (n = 1), and a
normal pancreas (n = 1). Prior to EUS, AIP was not specifically
suspected, but part of a broad differential (n = 3) or not suspected at
all (n = 2). Fine-needle aspiration was negative for neoplasia and AIP.
The TCB histology was definitive (n = 4) or suggestive (n = 1) for type 2
AIP. No complications developed. Conclusions: EUS-TCB may be safe and may provide sufficient material to definitively diagnose type 2 AIP.
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