Registries have recently emerged as valuable databases reflecting the actual results and time-trends of diagnostic and therapeutic methods. The first medical registries were constructed at the beginning of the 20th century, mainly in oncology. The requirements of a successful medical registry were worked out both on a national and international level. The Centre of Translational Medicine has 23 listed registries running. Some of them are very active (hepatitis, pancreatic diseases, ERCP), publishing their results in the national and international journals, while the activity of others is rather weak. The author presents his 10 years experience as a national coordinator of the European Registry on Helicobacter pylori management, resulting in many publications showing heterogeneous nature of the continental eradication results, time trends of prescriptions practices and common mistakes in treating the infection, which, if implemented in practice, will lead to improved patient care. This is, however, a very slow process.

Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis characterized clinically by frequent presentation with obstructive jaundice, with or without a pancreatic mass; histologically by a lympho­plasmacytic infiltrate and fibrosis; and therapeutically by a dramatic response to glucocorticoids. International Consensus Diagnostic Criteria divided AIP into type 1 and type 2. Type 1 AIP, also called lympho­plasmacytic sclerosing pancreatitis (LPSP), is part of IgG4-related disease called IgG4-related pancreatitis and other organs such as salivary glands and thyroid along with retroperitoneal fibrosis are usually in­volved. Type 2 AIP, also called idiopathic duct-centric pancreatitis (IDCP), is more localized to pancreas and is characterized by absence of elevated IgG4 levels and presence of granulocytic epithelial lesions although it can also be associated with ulcerative colitis. In this review, we discuss the current knowledge and recent advances relating to the diagnosis and therapy of AIP.

Autoimmune hepatitis (AIH) is a rare, immune-mediated, chronic inflammatory liver disease of unknown origin, characterised by elevated serum transaminase levels, hypergammaglobulinaemia, the presence of circulating autoantibodies, and distinctive histological findings, such as lymphoplasmacytic infiltrate with interface hepatitis. Clinical presentation of the disease is heterogenous and may pose diagnostic dilemmas. AIH requires lifelong treatment in a significant proportion of patients. The aim of treatment is to prevent the progression of liver disease (decompensated cirrhosis) and to avoid the need for liver trans­plantation. The management and care of AIH is often a professional challenge for the treating physician and requires an individualized approach. The cornerstone of drug therapy is steroid treatment to induce remission followed by maintenance therapy with azathioprine. This standard treatment regime has been proven to be effective in most of the cases. The goal of treatment is to achieve complete biochemical remission, defined by concomitant normalisation of transaminase and IgG levels to below the upper limit of normal (ULN). Close monitoring of both clinical signs and laboratory results is recommended after treatment initiation because of the potential side effects. Intolerance (10%) or a lack of response (15%) to standard therapy may require second- or third-line treatment with other immunosuppressive agents. In this regard, guidelines are less well-defined, and there is considerable variation in clinical practice. If there is uncertainty about the diagnosis or if the disease does not respond well to standard treatment or is otherwise difficult to treat, early contact and professional consultation with a specialist centre is strongly recommended. An international panel of experts may also be involved within the framework of the European Reference Network for Rare Liver Diseases (ERN RARE-LIVER), using a remote consultation system (CPMS).