The M-ANNHEIM classification of chronic pancreatitis: introduction of a unifying classification system based on a review of previous classifications of the disease

Schneider, Alexander; Löhr, J. Matthias; Singer, Manfred V.
February 2007
Journal of Gastroenterology;Feb2007, Vol. 42 Issue 2, p101
Academic Journal
Several classification systems of chronic pancreatitis have been proposed to provide a basis for treatment and research. All of these previous classifications were designed at the height of pancreatic research of their respective times; thus, each represented the most current knowledge available to pancreatologists at the time. However, none of these classifications provide simultaneously a simple standardized system for the clinical classification of chronic pancreatitis according to etiology, clinical stage, and severity of the disease, nor are they consistently useful for directing clinical practice and comparing interinstitutional data. Thus, we aimed to develop a new classification system of chronic pancreatitis to provide a framework for studying the interaction of various risk factors on the course of the disease. We reviewed the literature on the clinical course of all different forms of chronic pancreatitis, and we reviewed all previous classification systems of the disease. This approach provided a basis for the development of a new and unifying classification of chronic pancreatitis. We established the M-ANNHEIM multiple risk factor classification system based on the current knowledge of acute and chronic pancreatitis. This classification allows patients to be categorized according to the etiology, clinical stage, and severity of their disease. The severity of pancreatic inflammation was assessed using a scoring system that takes into account the clinical symptoms and treatment options of chronic pancreatitis. Finally, four hypothetical patients were categorized according to the M-ANNHEIM classification system to provide examples of its applicability in clinical practice. The M-ANNHEIM multiple risk factor classification system is simple, objective, accurate, and relatively noninvasive, and it incorporates etiology, different stages of the disease, and various degrees of clinical severity. This new classification system will be helpful for investigating the impact and interaction of various risk factors on the course of the disease and will facilitate the comparison and combination of interinstitutional data.


Related Articles

  • Incidence, Risk Factors and Clinical Course of Pancreatic Fluid Collections in Acute Pancreatitis. Cui, Mei; Kim, Kook; Kim, Ho; Han, Jimin; Kim, Hyunsoo; Cho, Kwang; Jung, Min; Cho, Chang; Kim, Tae // Digestive Diseases & Sciences;May2014, Vol. 59 Issue 5, p1055 

    Background: Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems. Acute fluid collections and pseudocyst formation are the most frequent complications of acute pancreatitis. Aims: The aims of this study...

  • Pancreatitis. Torpy, Janet M. // JAMA: Journal of the American Medical Association;4/2/2008, Vol. 299 Issue 13, p1630 

    This article presents information on pancreatitis designed and written for physicians to share with their patients. The pancreas and its roles in the human body and the gastrointestinal system are described, along with the risk factors for developing pancreatitis. Risk factors include alcohol...

  • Etiologies of Metatarsalgia.  // American Family Physician;11/1/1996, Vol. 54 Issue 6, p2108 

    Presents a summary of the article `Etiologies of Metatarsalgia' from the `Australian Family Physician' dated June, 1996. Metatarsalgia; Source or contributor to pain in metatarsalgia; Causes of metatarsaglia.

  • Cardiovascular Risk in Patients with Psoriatic Arthritis. Zhu, Tracy Y.; Li, Edmund K.; Lai-Shan Tam // International Journal of Rheumatology;2012, p1 

    Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. In addition to skin and joint involvement, there is increasing evidence suggesting that patients with PsA also have an increase in risk of clinical and subclinical cardiovascular diseases, mostly due to...

  • Large-scale association analysis identifies new risk loci for coronary artery disease. Deloukas, Panos; Kanoni, Stavroula; Willenborg, Christina; Farrall, Martin; Assimes, Themistocles L; Thompson, John R; Ingelsson, Erik; Saleheen, Danish; Erdmann, Jeanette; Goldstein, Benjamin A; Stirrups, Kathleen; König, Inke R; Cazier, Jean-Baptiste; Johansson, Åsa; Hall, Alistair S; Lee, Jong-Young; Willer, Cristen J; Chambers, John C; Esko, Tõnu; Folkersen, Lasse // Nature Genetics;Jan2013, Vol. 45 Issue 1, p25 

    Coronary artery disease (CAD) is the commonest cause of death. Here, we report an association analysis in 63,746 CAD cases and 130,681 controls identifying 15 loci reaching genome-wide significance, taking the number of susceptibility loci for CAD to 46, and a further 104 independent variants...

  • Update on the approaches to pancreatic disease. Abbruzzese, James L.; Lowy, Andrew M.; Pleskow, Douglas; Xiong, Henry Q. // Patient Care;Feb2006, Vol. 40 Issue 2, p15 

    Presents an update on the approaches to pancreatic disease. Diagnosis; Causes; Signs and symptoms.

  • A Common Variant of PNPLA3 (p.I148M) Is Not Associated with Alcoholic Chronic Pancreatitis. Rosendahl, Jonas; Tönjes, Anke; Schleinitz, Dorit; Kovacs, Peter; Wiegand, Johannes; Ruffert, Claudia; Jesinghaus, Moritz; Schober, Robert; Herms, Max; Grützmann, Robert; Schulz, Hans-Ulrich; Stickel, Felix; Werner, Jens; Bugert, Peter; Blüher, Matthias; Stumvoll, Michael; Böhm, Stephan; Berg, Thomas; Wittenburg, Henning; Mössner, Joachim // PLoS ONE;Jan2012, Vol. 7 Issue 1, p1 

    Background: Chronic pancreatitis (CP) is an inflammatory disease that in some patients leads to exocrine and endocrine dysfunction. In industrialized countries the most common aetiology is chronic alcohol abuse. Descriptions of associated genetic alterations in alcoholic CP are rare. However, a...

  • Increased Risk of Acute Pancreatitis in Patients with Type 2 Diabetes: An Observational Study Using a Japanese Hospital Database. Urushihara, Hisashi; Taketsuna, Masanori; Ying Liu; Oda, Eisei; Nakamura, Masaki; Nishiuma, Shinichi; Maeda, Rei // PLoS ONE;Dec2012, Vol. 7 Issue 12, p1 

    Background: Increased risks of acute pancreatitis in patients with type 2 diabetes mellitus have been reported recently in several countries. We aimed to estimate the risks of acute pancreatitis in Japanese patients with diabetes mellitus. Methods/Findings: We examined a large-scale hospital...

  • The Effect of PPE-Induced Emphysema and Chronic LPS-Induced Pulmonary Inflammation on Atherosclerosis Development in APOE*3-LEIDEN Mice. Khedoe, P. Padmini S. J; Wong, Man C.; Wagenaar, Gerry T. M.; Plomp, Jaap J.; van Eck, Miranda; Havekes, Louis M.; Rensen, Patrick C. N.; Hiemstra, Pieter S.; Berbée, Jimmy F. P. // PLoS ONE;Nov2013, Vol. 8 Issue 11, p1 

    Background: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary inflammation, airways obstruction and emphysema, and is a risk factor for cardiovascular disease (CVD). However, the contribution of these individual COPD components to this increased risk is unknown....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics