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01.03.2009 | Schwerpunkt: Generalisierte und organbezogene Autoimmunerkrankungen

Autoimmune Pankreatitis

verfasst von: A. Schneider, Prof. Dr. J.M. Löhr

Erschienen in: Die Innere Medizin | Ausgabe 3/2009

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Zusammenfassung

Die autoimmune Pankreatitis wird als eigenständige Form der Pankreatitis angesehen. Sie ist eine rätselhafte Erkrankung, die eine autoimmune Ätiologie mit den bekannten Ursachen der Pankreatitis verbindet. Morphologische Kennzeichen dieser Erkrankung sind Verengungen des pankreatischen Gangsystems und des Gallengangs durch eine periduktale lymphoplasmazelluläre Entzündung. Dies führt in vielen Fällen zum Ikterus aufgrund einer raumfordernden Läsion im Pankreaskopf, die einem duktalen Adenokarzinom des Pankreas ähnelt. Entsprechend werden viele Patienten einer Operation unterzogen. Histopathologisch kann die Erkrankung anhand IgG₄-positiver Plasmazellen diagnostiziert werden. Serologisch zeigen viele Patienten erhöhte Serum-IgG- und -IgG₄-Spiegel. Verschiedene Antikörper werden beschrieben. Die Assoziation mit anderen Autoimmunerkrankungen in diversen Organen ist häufig. Die autoimmune Pankreatitis spricht auf eine Steroidtherapie an, dies kann zur Abgrenzung der klinischen Differenzialdiagnose des Pankreaskarzinoms dienen. Die positive Diagnose der Autoimmunpankreatitis ist auch deshalb von Bedeutung, weil eine Cholangitis, insbesondere wenn Gallengänge betroffen sind, vor oder nach einer Operation als Komplikation auftreten kann.

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Titel: Autoimmune Pankreatitis
verfasst von: A. Schneider
Prof. Dr. J.M. Löhr
Publikationsdatum: 01.03.2009
Verlag: Springer-Verlag
Erschienen in: Die Innere Medizin / Ausgabe 3/2009
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI: https://doi.org/10.1007/s00108-008-2262-1

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