RT Journal Article SR Electronic T1 Long-term outcomes of autoimmune pancreatitis: a multicentre, international analysis JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 1771 OP 1776 DO 10.1136/gutjnl-2012-303617 VO 62 IS 12 A1 Hart, Phil A A1 Kamisawa, Terumi A1 Brugge, William R A1 Chung, Jae Bock A1 Culver, Emma L A1 Czakó, László A1 Frulloni, Luca A1 Go, Vay Liang W A1 Gress, Thomas M A1 Kim, Myung-Hwan A1 Kawa, Shigeyuki A1 Lee, Kyu Taek A1 Lerch, Markus M A1 Liao, Wei-Chih A1 Löhr, Matthias A1 Okazaki, Kazuichi A1 Ryu, Ji Kon A1 Schleinitz, Nicolas A1 Shimizu, Kyoko A1 Shimosegawa, Tooru A1 Soetikno, Roy A1 Webster, George A1 Yadav, Dhiraj A1 Zen, Yoh A1 Chari, Suresh T YR 2013 UL http://gut.bmj.com/content/62/12/1771.abstract AB 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.