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Current Gastroenterology Reports

Erschienen in:

17.10.2023

Immune Checkpoint Inhibitor-Induced (Type 3) Autoimmune Pancreatitis

verfasst von: Anusha Shirwaikar Thomas, Suresh T. Chari

Erschienen in: Current Gastroenterology Reports | Ausgabe 10/2023

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Abstract

Purpose of Review

Immune checkpoint inhibitors (ICI) have revolutionized cancer care and work primarily by blocking CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), and/or PD-1 (programmed cell death protein 1), and/or PD-L1 (programmed death-ligand 1), thereby providing highly efficacious anti-tumor activity. However, this unmitigated immune response can also trigger immune related adverse events (irAEs) in multiple organs, with pancreatic irAEs (now referred to as type 3 Autoimmune pancreatitis (AIP) being infrequent.

Recent Findings

Type 3 AIP is a drug-induced, immune mediated progressive inflammatory disease of the pancreas that may have variable clinical presentations viz., an asymptomatic pancreatic enzyme elevation, incidental imaging evidence of pancreatitis, painful pancreatitis, or any combination of these subtypes. Management is largely supportive with intravenous fluid hydration, pain control and holding the inciting medication. Steroids have not been shown to demonstrate a clear benefit in acute management. A rapid development pancreatic atrophy is observed on imaging as early as 1 year post initial injury.

Summary

Type 3 AIP is a chronic inflammatory disease of the pancreas that though predominantly asymptomatic and mild in severity can lead to rapid organ volume loss regardless of type of clinical presentation and despite steroid therapy.

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Titel: Immune Checkpoint Inhibitor-Induced (Type 3) Autoimmune Pancreatitis
verfasst von: Anusha Shirwaikar Thomas
Suresh T. Chari
Publikationsdatum: 17.10.2023
Verlag: Springer US
Erschienen in: Current Gastroenterology Reports / Ausgabe 10/2023
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI: https://doi.org/10.1007/s11894-023-00885-6

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Abstract

Purpose of Review

Recent Findings

Summary

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