Table 1.
Characteristics | Drug-induced pancreatitis | Idiopatic IBD-associated pancreatitis | Autoimmune pancreatitis |
Epidemiology | Pediatric patients Elderly patients Females > males | Males >> females | Male-female 2:1 (type 1) Male-female: 1:1 (type 2) |
Age at presentation of pancreatitis | Any ages | 20-40 yr | 60-65 yr (type 1) 45-50 yr (type 2) |
Clinical presentation | Abdominal pain | Abdominal pain Exocrine pancreatic insufficiency | Jaundice Mild abdominal pain Diabetes |
Sierology | Elevated pancreatic enzymes Normal IgG4 | Elevated pancreatic enzymes Normal IgG4 | Normal or slightly elevated pancreatic enzymes Elevated IgG4 (in type 1) |
Imaging | Normal pancreas or oedematous pancreatitis | Normal pancreas or oedematous pancreatitis Diffuse pancreatic enlargement or long/multiple MPD narrowing No calcifications or pseudocysts | Diffuse pancreatic enlargement or long/multiple MPD narrowing No calcifications or pseudocysts |
Key point | Direct correlation between resolution of symptoms and drug withdrawal Symptoms recurrence with re-challenge test | Exclusion of other causes of pancreatitis (drug, lithiasis, alcohol...) | Rapid response to steroid with radiologically demonstrable resolution or marked clinical improvement |
MPD: Main pancreatic duct; IBD: Inflammatory bowel disease.