International Consensus Diagnostic Criteria for Autoimmune Pancreatitis and Its Japanese Amendment Have Improved Diagnostic Ability over Existing Criteria

Table 1

Comparison of 6 major diagnostic criteria systems for AIP.

	JPS-2006	Korean	Asian	HISORt		ICDC		JPS-2011
(I) Imaging findings	Mandatory	Mandatory	Mandatory	Not mandatory		Not mandatory		Not mandatory
				Typical	Atypical	Typical	Indeterminate	Typical	Indeterminate
(a) Parenchymal imaging	Swelling	Swelling	Swelling	Swelling	Focal mass/; calcification/; atrophy, etc.	Diffuse swelling	Segmental/; focal swelling	Diffuse swelling	Segmental/; focal swelling
(b) Ductal imaging	ERCP; irregular; narrowing	ERCP/MRCP; irregular; narrowing	ERCP; irregular; narrowing	Irregular narrowing	Focal duct stricture	Irregular narrowing			ERCP¶; Irregular narrowing
(II) Serology	𝛾-Globulin/; IgG/IgG4/; autoantibodies	IgG/IgG4/; autoantibodies	IgG/IgG4/; autoantibodies	IgG4		IgG4		IgG4
(III) Histology	LPSP	LPSP/IgG4-positive; plasma cells	LPSP/IgG4-positive; plasma cells	LPSP/IgG4-positive; plasma cells		LPSP/IgG4-positive; plasma cells; IDCP/GEL^†		LPSP/IgG4-positive; plasma cells
(IV) Other organ involvement	Not included	Includes; histological findings	Not included	Includes; histological findings		Includes; histological findings/; clinical findings^Φ		Includes; histological findings/; clinical findings
(V) Response to steroid	Not included	Includes; pancreatic lesion/; extrapancreatic lesions	Optional; pancreatic lesion	Includes; pancreatic lesion/; extra-pancreatic lesions		Includes; pancreatic lesion/; extra-pancreatic lesions		Includes; pancreatic lesion/; extra-pancreatic lesions
Diagnosis	I + II; I + III	I + II; I + III; I + IV; I + V	I + II; I + III	III; I (typical) + II; I (atypical) + II/IV + V		Shown in Table 3		Shown in Table 4

¶JPS-2011 requires evaluation by ERP in indeterminate imaging evidence.
^†Diagnosis of type 2 AIP requires histologically confirmed IDCP/GEL.
^ΦFindings in type 1 AIP are sclerosing cholangitis, retroperitoneal fibrosis, Mikulicz disease, and renal disease. Finding in type 2 AIP is inflammatory bowel disease.
ERCP: endoscopic retrograde pancreatocholangiography; LPSP: lymphoplasmacytic sclerosing pancreatitis; IDCP: idiopathic duct-centric chronic pancreatitis; GEL: granulocytic epithelial lesion.