Autoimmune pancreatitis (AIP) is a rare form of
chronic pancreatitis that develops against a background of chronic
fibroinflammation. It may occur in isolation or as a component of
Immunoglobulin G4 - related disease (IgG4-RD). There are two types. Type 1 AIP
is more common in the elderly population. The most common symptom is
obstructive jaundice. There are many undiagnosed cases. The diagnostic approach
continues to be updated in recent years. Differential diagnosis with pancreatic
cancer is important at the time of diagnosis. Differential diagnosis can be
made with imaging methods and corticosteroid treatment response.
Corticosteroids are the mainstay of treatment of Type 1 AIP in the geriatric
population. Corticosteroid treatment should be used long-term. While decreasing
the corticosteroid dose in the first year, care should be taken in terms of
recurrence. Corticosteroid discontinuation earlier than one year increases the
recurrence rate, and side effects may be more pronounced with long-term use of
corticosteroids in the elderly population. Azathioprine (AZA) may be another
option in the elderly population where side effects are more prominent.
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