AUTHOR=Jin Qiwen , Ge Yongpeng , Chen Xixia , Tan Chang , Huang Zhenguo , Wang Bei , Zhang Bo , Peng Qinglin , Wang Xiaodi , Wang Guochun 

TITLE=The Clinical Phenotype of Chinese Patients With Autoimmune Pancreatitis Differs Significantly From Western Patients

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.771784

DOI=10.3389/fmed.2022.771784

ISSN=2296-858X

ABSTRACT=Aim: To characterize the clinical features of autoimmune pancreatitis (AIP) in China and compare differences between our Chinese cohort and Western cohorts. Methods: This was a retrospective study of patients with AIP that was carried out in the China-Japan Friendship Hospital between January 2010 and April 2021. We included a total of 50 patients (46 males and 4 females) aged between 27 and 86 years who fulfilled the international Consensus Diagnostic (ICD) Criteria. For comparative purposes, we included data from seven representative Western cohorts. Result: When comparing Chinese and Western patients, we found that obstructive jaundice was the most frequent initial symptom(68%vs43%,P<0.001).Extra-pancreatic organ involvement was more common in Chinese patients(68%vs30%，P<0.001).Sclerosing cholangitis was the most frequent extrapancreatic lesion(48%vs24%,P=0.001).The elevation of serum IgG4 was more obvious in our cohort(86%vs49%,P<0.001).Conversely, the rates of ANA-positivity were significantly higher in Western populations(17%vs50%,P=0.006).With regards to imaging, diffuse swelling was significantly more common in China(44%vs27%,P=0.021).Steroid therapy was used more frequently in our Chinese patients(84%vs59%,P=0.001).The steroid-response rate was also significantly higher in our Chinese patients(85%vs54%,P=0.001); However, the rate of resection was higher in Western cohorts (2%vs31%,P<0.001).There was no significant difference between the two populations with regards to recurrence rate (33%vs33%,P=1.000). Conclusion: This study identified significant differences between Chinese and Western populations of patients with AIP. Within the Chinese population, AIP was more likely to have jaundice and extra-pancreatic organ involvement, and elevated serum IgG4 levels. Chinese patients were also showed favorable responses to treatment with glucocorticoids.