Autoimmune pancreatitis — ESEGH MCQ
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Correct answer: B — Start systemic glucocorticoid induction with specialist monitoring
The best answer is “Start systemic glucocorticoid induction with specialist monitoring”. Glucocorticoids are standard induction therapy for symptomatic type 1 autoimmune pancreatitis after malignancy has been excluded. “Observe without treatment despite obstructive jaundice” is less appropriate because symptomatic active disease is an indication for induction therapy “Perform a Whipple procedure despite exclusion of malignancy” is less appropriate because major oncological surgery is not first-line treatment for established autoimmune pancreatitis “Use antibiotics alone for 6 weeks” is less appropriate because antibiotics do not treat IgG4-mediated inflammation “Use a steroid trial before excluding pancreatic cancer” is less appropriate because malignancy must be carefully excluded before glucocorticoid treatment
Reference: European guideline on IgG4-related digestive disease: https://pmc.ncbi.nlm.nih.gov/articles/PMC7437085/