TY - JOUR T1 - Long-term outcomes of autoimmune pancreatitis: a multicentre, international analysis JF - Gut JO - Gut SP - 1771 LP - 1776 DO - 10.1136/gutjnl-2012-303617 VL - 62 IS - 12 AU - Phil A Hart AU - Terumi Kamisawa AU - William R Brugge AU - Jae Bock Chung AU - Emma L Culver AU - László Czakó AU - Luca Frulloni AU - Vay Liang W Go AU - Thomas M Gress AU - Myung-Hwan Kim AU - Shigeyuki Kawa AU - Kyu Taek Lee AU - Markus M Lerch AU - Wei-Chih Liao AU - Matthias Löhr AU - Kazuichi Okazaki AU - Ji Kon Ryu AU - Nicolas Schleinitz AU - Kyoko Shimizu AU - Tooru Shimosegawa AU - Roy Soetikno AU - George Webster AU - Dhiraj Yadav AU - Yoh Zen AU - Suresh T Chari Y1 - 2013/12/01 UR - http://gut.bmj.com/content/62/12/1771.abstract N2 - Objective Autoimmune pancreatitis (AIP) is a treatable form of chronic pancreatitis that has been increasingly recognised over the last decade. We set out to better understand the current burden of AIP at several academic institutions diagnosed using the International Consensus Diagnostic Criteria, and to describe long-term outcomes, including organs involved, treatments, relapse frequency and long-term sequelae. Design 23 institutions from 10 different countries participated in this multinational analysis. A total of 1064 patients meeting the International Consensus Diagnostic Criteria for type 1 (n=978) or type 2 (n=86) AIP were included. Data regarding treatments, relapses and sequelae were obtained. Results The majority of patients with type 1 (99%) and type 2 (92%) AIP who were treated with steroids went into clinical remission. Most patients with jaundice required biliary stent placement (71% of type 1 and 77% of type 2 AIP). Relapses were more common in patients with type 1 (31%) versus type 2 AIP (9%, p<0.001), especially those with IgG4-related sclerosing cholangitis (56% vs 26%, p<0.001). Relapses typically occurred in the pancreas or biliary tree. Retreatment with steroids remained effective at inducing remission with or without alternative treatment, such as azathioprine. Pancreatic duct stones and cancer were uncommon sequelae in type 1 AIP and did not occur in type 2 AIP during the study period. Conclusions AIP is a global disease which uniformly displays a high response to steroid treatment and tendency to relapse in the pancreas and biliary tree. Potential long-term sequelae include pancreatic duct stones and malignancy, however they were uncommon during the study period and require additional follow-up. Additional studies investigating prevention and treatment of disease relapses are needed. ER -