Diabetes

Autoimmune damage to the pancreas

Autoimmune pancreatitis is a systemic pathology, against which not only the pancreas is affected, but also other internal organs. The disease is quite rare, not fully understood, so the exact causes of the development are unknown.

The protective functions of the human body begin to produce specific antibodies that disrupt the structure of the cells of the pancreas, have an aggressive effect on the biliary ducts, kidneys, lymph nodes, lungs, gastrointestinal tract.

The disease is attributed to pathologies that are characterized by a chronic course. They last more than six months. Often there are periods of exacerbation, remission is relatively short.

During the inflammatory process, that is, during exacerbation, there is a decrease in the exocrine activity of the internal organ. Consider what clinical symptoms are accompanied by autoimmune damage to the pancreas, what treatment is prescribed.

Clinic

The etiology of the pathological process in the body is not clear. Due to a violation of the immune system begins to attack its own cells. The autoimmune form of pathology is often combined with disease — Sjogren's syndrome, an inflammatory disorder in the gastrointestinal tract.

The disease is lifelong in nature through the transition to the chronic form, when acute attacks are replaced by remission. The patient develops complications in 70% of the pictures - diabetes mellitus, destruction of the tissues of the pancreas, pseudocysts are formed.

Suspect pathology is hard. Often it takes place against the background of the absence of pronounced clinical manifestations. Sometimes there are no intense symptoms in the acute phase. Often patients learn about their illness when complications already develop.

A patient may experience the following symptoms:

  • Pain develops in the upper abdomen, it can last for several minutes or a couple of hours. The severity of pain is moderate.
  • The yellowness of the surface of the skin and mucous membranes, biological fluid - saliva or tears. Occurs due to the disorder of the flow of bile into the duodenum due to the narrowing of the ducts of the pancreas. Additional signs include dark urine, clarified feces, skin symptoms - itching, burning.
  • Dyspeptic symptoms. Patients complain of loss of appetite, nausea and vomiting, increased gas formation, bitterness in the oral cavity.
  • There is a violation of the intrasecretory activity of the gland, which leads to the development of diabetes. The peculiarity of this disease in autoimmune pancreatitis is that the pathology is characterized by a favorable course with a possible full recovery.
  • Emotional lability, depressed mood, decreased performance and other asthenic manifestations.

There may also be specific symptoms due to lesions of an organ. For example, when lung lesions appear shortness of breath, there is a feeling of lack of oxygen.

If there are problems with the kidneys, then renal failure is diagnosed, protein appears in the urine.

Types of autoimmune gland inflammation

Autoimmune diseases of the pancreas are divided into several varieties. Depending on the histological pattern - changes in the structure of the pancreas, identified as a result of microscopic diagnosis, two types of pancreatitis are distinguished.

The first is a sclerosing lymphoplasmacytic form. The second type is the idiopathic form of duct-concentric pancreatitis with existing granulocytic lesions of epithelial tissue. The differences are only in histological aspects. In other words, they are determined only in laboratory conditions; there are no other methods of detection.

Also, pathologies are classified by the presence of autoimmune pathologies. There are two types:

  1. An isolated species is diagnosed in patients who have not found other autoimmune disruptions in the body.
  2. The syndrome of autoimmune pancreatitis is a disease that develops against the background of other autoimmune pathologies.

Depending on the site of localization of the lesion, pancreatitis is of diffuse type - the entire internal organ and the focal type are affected - some segments of the pancreas are affected, in most of the pictures inflammation is located in the head.

Diagnosis and treatment

When referring to a doctor, a patient’s medical history is collected, and a survey is conducted for complaints of a person. Assigned to laboratory tests and instrumental diagnostic methods.

Laboratory tests include complete blood count, body sugar concentration, glycosylated hemoglobin test, biochemical blood test, tumor marker test, and immunoglobulin content. Assign instrumental diagnostics - ultrasound of the abdominal cavity, CT, MRI, biopsy, and others.

In medical practice, there were cases when the disease leveled out on its own without the use of medicines. However, most of the paintings require a conservative treatment of autoimmune pancreatitis.

Patients are prescribed diet number 5. With the development of diabetes mellitus, the main recommendation is proper nutrition with restriction of the use of granulated sugar. Conservative therapy involves the use of the following medications:

  • Corticosteroids are artificial analogues of adrenal hormones, their use is the basis of the therapeutic course. The duration of treatment is about two weeks. Some patients require more long-term treatment with small dosages.
  • Immunosuppressants - a group of drugs that inhibit excessive activity of the immune system. They are recommended if the effect of using glucocorticosteroids is insufficient or if it is impossible to use them.
  • Antispasmodics allow to stop pain, which develops as a result of narrowing of the pancreas ducts.
  • To improve the process of digestion of consumed food enzyme preparations are prescribed.
  • If there is damage to the stomach, then proton pump inhibitors are prescribed. They help restore mucous surfaces.
  • Short-acting insulin is used to normalize blood sugar levels in the event of a "sweet" disease. Sometimes used insulin prolonged effect.

Surgical treatment consists in the mechanical restoration of the normal lumen of the gland ducts and bile ducts. The operative path is necessary in cases where a significant reduction in the diameter of the channels is diagnosed and there is no result from the use of glucocorticosteroids.

The prognosis for an autoimmune form of the disease is due to the existing complications associated with autoimmune pathologies and the presence / absence of diabetes. Prevention does not exist, as the medicine does not know the exact factors leading to an attack of the immunity of its own cells.

The causes and methods of treatment of pancreatitis are discussed in the video in this article.

Watch the video: Autoimmune Pancreatitis-Mayo Clinic (September 2019).