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- Title
Autoimmune Pancreatitis: Clinical and Radiological Features and Objective Response to Steroid Therapy in a UK Series.
- Authors
Church, Nicholas I.; Pereira, Stephen P.; Deheragoda, Maesha G.; Sandanayake, Neomal; Amin, Zahir; Lees, William R.; Gillams, Alice; Rodriguez-Justo, Manuel; Novelli, Marco; Seward, Edward W.; Hatfield, Adrian R.W.; Webster, George J. M.
- Abstract
OBJECTIVE: Most cases of autoimmune pancreatitis (AIP) have been reported from Japan. We present data on a UK series, including clinical and radiological features at presentation, and longitudinal response to immunosuppression. METHODS: Over an 18-month period, all patients diagnosed in our center with AIP were studied. Endoscopic biliary stenting was performed as required, and patients were treated with prednisolone, with response assessed longitudinally. In cases of disease relapse following steroid reduction, azathioprine was instituted. RESULTS: Eleven patients met diagnostic criteria for AIP. Diffuse pancreatic enlargement was seen in eight patients (73%), and pancreatic duct strictures in all. Seven patients required biliary stents. Extrapancreatic involvement occurred in all, including intrahepatic stricturing and renal disease. Eight weeks after starting steroids, the median serum bilirubin level had fallen from 38 μmol/L to 11 μmol/L ( P= 0.001), and ALT from 97 IU/L to 39 IU/L ( P= 0.002). Stents were removed in all cases, with no recurrence of jaundice. Improvements in mass lesions and pancreaticobiliary stricturing occurred in all patients. During a median 18-month follow-up, six patients relapsed, four of whom responded to azathioprine. Two patients discontinued steroids and remained well. CONCLUSIONS: Extrapancreatic disease was an important feature of AIP in this UK series. Initial response to immunosuppressive therapy was excellent, but disease relapse was common. Optimal long-term management remains to be established.
- Subjects
UNITED Kingdom; CLINICAL trials; STEROID drugs; PANCREATITIS treatment; AUTOIMMUNE diseases; MEDICAL radiology
- Publication
American Journal of Gastroenterology (Springer Nature), 2007, Vol 102, Issue 11, p2417
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2007.01531.x