Autoimmune pancreatitis (AIP) is an infrequently recognized disorder of presumed autoimmune etiology that is associated with characteristic clinical, histologic, and morphologic findings. Multiple organs, such bile ducts, salivary glands, kidneys and lymph nodes, can be involved either synchronously or metachronously. It is one of the few autoimmune conditions that predominantly affects male subjects in the fifth and sixth decades of life. This autoimmune disease can mimic pancreatic cancer by its clinical symptoms, including weight loss and jaundice. Furthermore imaging findings may include a mass of the pancreas.
Autoimmune pancreatitis occurs in twice as many men as women. The initial presentation usually occurs between ages 50-60, but patients can also develop autoimmune pancreatitis as early as age 30 as well as late in life. The disease can occur as alone or in association with other autoimmune disorders including sclerosing cholangitis, primary biliary cirrhosis, inflammatory bowel disease, rheumatoid arthritis, hypothyroidism, sarcoidosis, and Sjogren’s syndrome.
Types
- Type 1 AIP is also called IgG4-related pancreatitis and is part of a disease called IgG4-related disease (IgG4-RD) that often affects multiple organs including the pancreas, bile ducts in the liver, salivary glands, kidneys and lymph nodes.
- Type 2 AIP seems to affect only the pancreas, although about one-third of people with type 2 AIP have associated inflammatory bowel disease.
Both subtypes of autoimmune pancreatitis are treated with steroids, which in many people dramatically improve the condition.
Causes
It is a type of chronic pancreatitis characterised by a heterogenous autoimmune inflammatory process in which prominent lymphocytic infiltration with associated fibrosis of the pancreas causes organ dysfunction.
The cause is unknown though there is a strong basis for an autoimmune process where antibody reaction against carbonic anhydrase and lactoferrin has been postulated.
Risk Factors
People with type 1 autoimmune pancreatitis often –
- Are over age 60
- Are male
- Have multiple organ involvement including the bile ducts (IgG4-related sclerosing cholangitis), the salivary glands (IgG-related sialadenitis), or the lungs (IgG4-related pulmonary disease)
- Have retroperitoneal fibrosis (RPF), which is the formation of extra fibrous tissue in the area behind the stomach and intestine
- Have lymph node enlargement (lymphadenopathy), low thyroid (hypothyroidism) or kidney disease
People with type 2 autoimmune pancreatitis –
- Are often over age 40 (one or two decades younger than those with type 1)
- Are as likely to be female as male
- Have a 30 percent chance of having inflammatory bowel disease, such as ulcerative colitis
Symptoms
Pancreatic cancer symptoms can include –
- Dark urine
- Pale stools or stools that float in the toilet
- Yellow skin and eyes (jaundice)
- Pain in your upper abdomen or middle part of your back
- Nausea and vomiting
- Weakness or extreme tiredness
- Loss of appetite or feelings of fullness
- Weight loss for no known reason
The most common sign of autoimmune pancreatitis, present in about 80 percent of people, is painless jaundice, caused by blocked bile ducts. AIP can also cause weight loss. Many people with autoimmune pancreatitis have masses in the pancreas and other organs, which can be misdiagnosed as cancer.
Treatment
Steroids – Symptoms of autoimmune pancreatitis often improve after a short course of prednisolone (Prelone). Many people respond quickly, even dramatically. Sometimes people get better without any treatment.
Immunosuppressants and immunomodulators – About 30 to 50 percent of the time, AIP returns, requiring additional treatment, sometimes long term. Immunosuppresants and immunomodulators include mycophenolate (CellCept), mercaptopurine (Purinethol, Purixan), azathioprine (Imuran, Azasan) and rituximab (Rituxan). In general, they have been used in small sample groups and long-term benefits are still being studied.
Treatment for pancreatic insufficiency – If a person has insufficient pancreatic enzymes, he may need supplementary enzymes
Treatment for diabetes – If a person has diabetes, he will need appropriate treatment.
Monitoring of other organ involvement (OOI) – Type 1 AIP often is associated with other organ involvement, including enlarged lymph nodes and salivary glands, scarring of the bile ducts, liver inflammation, and kidney disease.
Alternative Treatment
Grape Seed Extract – Grape seed extract is a very strong anti-inflammatory but it is also one of the most powerful antioxidants on earth and one of the few that will cross the blood-brain barrier. According to research grape seed extract causes cancer cells to die but more importantly grape seed extract helps relieve nausea and pain that are two rotten symptoms of pancreatitis
Curcumin puts out the fire of inflammation and so helps control pain. Curcumin is a powerful pain reliever and one of the best pancreatitis supplements. It fights pancreas inflammation,. Curcumin is also a very strong antioxidant which seems to inhibit cancer growth by actually causing cancer cells to die.
Vitamin C is another antioxidant, anti-inflammatory and essential nutrient. Vitamin C can do so many things, in combination with grape seed extract and curcumin. Those three pancreatitis supplements in combination are extremely powerful.
Vitamins, Minerals and Antioxidants are important pancreatitis supplements simply because with pancreatitis patients can often suffer from malabsorption which simply means they do not absorb the nutrients from food. Extra vitamins, minerals and antioxidants may be very helpful in providing more energy and all-around better health.
Digestive Enzymes are important pancreatitis supplements simply because the pancreas produces digestive enzymes and the less the pancreas has to work the better. If the pancreas has sustained a large amount of damage it may not produce enough enzymes to digest thefood and of course this makes an enzyme supplement mandatory.
Chromium picolinate mineral helps maintain stable blood sugar levels so the pancreas doesn’t have to work overtime secreting insulin to move sugar out of the blood into cells.
Calcium & Magnesium work hand in hand to promote the health of all glands.
Vitamin B Complex helps relieve stress on the pancreas, and vitamins B-3 and B-5 in particular are important for fat and carbohydrate metabolism.
Dandelion root is an herbal supplement that is commonly used to help treat pancreatitis. Studies suggest that dandelion root helps stimulate and strengthen your pancreas and may improve the function of other organs, too, including the kidneys, spleen and stomach.
Omega 3 fatty acids helps in treating High Triglycerides, inflammation, gallstones. It also reduce the chance of a recurrent episode if you have a history of pancreatitis.
Milk thistle is one of those cholagogue herbs, which have been trusted by herbalists for over thousands of years to treat a damaged, liver, pancreas and stomach. Silymarin, a type of flavonoid has given this herbaceous plant the power to deal with liver damages. Being used as a liver tonic, the extracts of milk thistle help to neutralize all sorts of liver damages, other than protecting the liver as a whole. Other than that, milk thistle is also a source of vitamin E, which helps to treat and regenerate the cells of the liver and pancreas, which get damaged as a result of pancreatitis.
Licorice root has been used as a traditional Chinese herb for treating an array of health disorders, which also includes pancreatitis. Deglycyrrhizinated licorice (DGL) is one of the major bioactive compounds found in licorice, which can be the major reason behind the herb’s effectiveness for treating pancreatitis
Reference –
https://www.patientslikeme.com/conditions/1881-autoimmune-pancreatitis
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138604
http://www.hindawi.com/journals/ijr/2012/597643/