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 Phil A Hart
A1 Terumi Kamisawa
A1 William R Brugge
A1 Jae Bock Chung
A1 Emma L Culver
A1 László Czakó
A1 Luca Frulloni
A1 Vay Liang W Go
A1 Thomas M Gress
A1 Myung-Hwan Kim
A1 Shigeyuki Kawa
A1 Kyu Taek Lee
A1 Markus M Lerch
A1 Wei-Chih Liao
A1 Matthias Löhr
A1 Kazuichi Okazaki
A1 Ji Kon Ryu
A1 Nicolas Schleinitz
A1 Kyoko Shimizu
A1 Tooru Shimosegawa
A1 Roy Soetikno
A1 George Webster
A1 Dhiraj Yadav
A1 Yoh Zen
A1 Suresh T Chari
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.