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=9

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=<sec><title>Aim</title><p>To characterize the clinical features of autoimmune pancreatitis (AIP) in China and compare differences between our Chinese cohort and Western cohorts.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Result</title><p>When comparing Chinese and Western patients, we found that obstructive jaundice was the most frequent initial symptom (68 vs. 43%, <italic>P</italic> &lt; 0.001). Extra-pancreatic organ involvement was more common in Chinese patients (68 vs. 30%, <italic>P</italic> &lt; 0.001). Sclerosing cholangitis was the most frequent extrapancreatic lesion (48 vs. 24%, <italic>P</italic> = 0.001). The elevation of serum IgG4 was more obvious in our cohort (86 vs. 49%, <italic>P</italic> &lt; 0.001). Conversely, the rates of ANA-positivity were significantly higher in Western populations (17 vs. 50%, <italic>P</italic> = 0.006). With regards to imaging, diffuse swelling was significantly more common in China (44 vs. 27%, <italic>P</italic> = 0.021). Steroid therapy was used more frequently in our Chinese patients (84 vs. 59%, <italic>P</italic> = 0.001). The steroid-response rate was also significantly higher in our Chinese patients (85 vs. 54%, <italic>P</italic> = 0.001); However, the rate of resection was higher in Western cohorts (2 vs. 31%, <italic>P</italic> &lt; 0.001). There was no significant difference between the two populations with regards to recurrence rate (33 vs. 33%, <italic>P</italic> = 1.000).</p></sec><sec><title>Conclusion</title><p>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.</p></sec>