Outcome of Patients With Type 1 or 2 Autoimmune Pancreatitis

Autoimmune Pancreatitis Exocrine pancreatic insufficiency
DOI: 10.1038/ajg.2010.314 Publication Date: 2010-08-24T15:20:07Z
ABSTRACT
Autoimmune pancreatitis (AIP) is better described than before, but there still no international consensus for definition, diagnosis, and treatment. Our aims were to analyze the short- long-term outcome of patients with focus on pancreatic endocrine exocrine functions, search predictive factors relapse insufficiency, compare type 1 2 AIP.All consecutive followed up AIP in our center between 1999 2008 included. Two groups defined: (a) meeting HISORt (Histology, Imaging, Serology, Other organ involvement, Response steroids) criteria; (b) definitive/probable including those histologically confirmed idiopathic duct-centric ("definitive") or suggestive imaging, normal serum IgG4, response steroids ("probable"). AIP-related events exocrine/endocrine insufficiency looked during follow-up. Predictive analyzed.A total 44 (22 males), median age 37.5 (19-73) years, included: 28 (64%) 16 (36%) AIP. First-line treatment consisted resection 59 27% patients, respectively. Median follow-up was 41 (5-130) months. Steroids effective all treated patients. Relapse observed 12 (27%), after a delay 6 months (1-70). Four received azathioprine because steroid resistance/dependence. High IgG4 level, pain at time other involvement associated (P<0.05). At end point, atrophy 35% Exocrine insufficiencies present 34 39% univariate analysis, factor although female gender (P=0.04), increasing (P=0.006), (P=0.001) occurrence diabetes. Steroid/azathioprine did not prevent insufficiency. Type more frequently inflammatory bowel disease (31 3%, respectively), rates similar both groups.Relapse occurs frequent high levels diagnosis. Pancreatic functional occur one-third within 3 years The AIP, condition often disease, different from that except
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