American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is true regarding the response to glucocorticoids in type 1 autoimmune pancreatitis?

1. All patients relapse

2. Relapse is common

3. None relapse

4. Only half respond initially

The correct answer is: Relapse is common

The statement that relapse is common in patients with type 1 autoimmune pancreatitis in response to glucocorticoid treatment reflects the clinical observations associated with this condition. Type 1 autoimmune pancreatitis often presents in episodes, and while glucocorticoids can be effective in managing the inflammation and symptoms, a significant proportion of patients do experience relapse after the initial treatment. Autoimmune pancreatitis itself is part of a broader category of autoimmune disorders, and these types of diseases are often characterized by fluctuations in activity. In practice, although glucocorticoids can lead to an initial response, the underlying immune dysregulation may result in recurrent flares of pancreatitis once the treatment is tapered down or if the therapy is not adequately sustained over time. This pattern underscores the importance of long-term follow-up and sometimes prolonged treatment to maintain remission. Moreover, understanding the potential for relapse highlights the complexity of managing autoimmune pancreatitis compared to other forms of pancreatitis, where the etiology and treatment response might differ significantly.