Expanded analysis - Autoantibodies in Autoimmune Pancreatitis (type 2, AIP2) (575)

Tests in package

Anti-Carboanhydrase II antibodies, CASPR2 antibodies, DNA-bound lactoferrin antibodies

Indication

Suspicion of Autoimmune Pancreatitis (type 2, AIP2)

Clinical background

Autoimmune pancreatitis (AIP) is caused by immune-mediated inflammation of the pancreas. The inflammation can give rise to tumor-like granulomas which can be misinterpreted as malignant tumors but also diffuse inflammation without granuloma can occur. AIP is an unusual disease; The prevalence 1/100 000 has been reported in a Japanese population, but the true incidence is unclear because many cases are believed to be undiagnosed.
There are two different types of AIP: type 1 (AIP1, so-called "classic" autoimmune pancreatitis) and type 2 (AIP2).
AIP1 is the most common and accounts for about 80% of cases that are usually men over the age of 50. The marker for AIP1 is elevated serum IgG4 and is detected in 80% of cases.
AIP2 is less common and is estimated to account for 20-30% of cases with AIP. Compared to AIP1, AIP2 affects slightly younger people and is as common in women as in men. The presence of antibodies against Carbohydrate II and Lactoferrin has been demonstrated in up to 75% of people with AIP2. Even IgG4 may be elevated in a smaller proportion of AIP2.
This panel offers analysis of Carbohydrate II antibodies and Lactoferrin (DNA bound) antibodies.

 

References

Khandelwal et al. (2014). Recent advances in the diagnosis and management of autoimmune pancreatitis. Am J Roentgenol. May;202(5):1007-21. PMID: 24758653
Sugumar A. (2012). Diagnosis and management of autoimmune pancreatitis. Gastroenterol Clin North Am. 2012 Mar;41(1):9-22. PMID: 22341247


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