American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the cornerstone of treatment for autoimmune pancreatitis?

1. Proton pump inhibitors

2. Surgical intervention

3. Glucocorticoids

4. Immunosuppressants

The correct answer is: Glucocorticoids

The cornerstone of treatment for autoimmune pancreatitis is glucocorticoids. This condition is characterized by inflammatory changes in the pancreas that can lead to abdominal pain and pancreatic insufficiency. Glucocorticoids, such as prednisone, are highly effective in managing the inflammation associated with autoimmune pancreatitis. They work by suppressing the immune response, which addresses the underlying cause of the pancreatic inflammation. The use of glucocorticoids not only alleviates symptoms but also can lead to a significant decrease in pancreatic swelling and an improvement in pancreatic function. Often, patients will experience a rapid and marked response to glucocorticoid therapy, which helps to confirm the diagnosis of autoimmune pancreatitis. Other treatments such as proton pump inhibitors may relieve some digestive symptoms but do not address the inflammation itself. Surgical intervention is rarely needed and is reserved for complications or when there is uncertainty about the diagnosis. Immunosuppressants can play a role in cases that do not respond to glucocorticoids, but they are not the first-line treatment. Therefore, glucocorticoids remain the primary and most effective approach in managing autoimmune pancreatitis.