TY - JOUR
T1 - Autoimmune pancreatitis
T2 - Differences between the focal and diffuse forms in 87 patients
AU - Frulloni, Luca
AU - Scattolini, Chiara
AU - Falconi, Massimo
AU - Zamboni, Giuseppe
AU - Capelli, Paola
AU - Manfredi, Riccardo
AU - Graziani, Rossella
AU - D'Onofrio, Mirko
AU - Katsotourchi, Anna Maria
AU - Amodio, Antonio
AU - Benini, Luigi
AU - Vantini, Italo
PY - 2009/9
Y1 - 2009/9
N2 - OBJECTIVES:Autoimmune pancreatitis (AIP) is a particular type of chronic pancreatitis that can be classified into diffuse and focal forms. The aim of this study was to analyze clinical and instrumental features of patients suffering from the diffuse and focal forms of AIP.METHODS:AIP patients diagnosed between 1995-2008 were studied.RESULTS:A total of 87 AIP patients (54 male and 33 female patients, mean age 43.415.3 years) were studied. Focal-type AIP was diagnosed in 63% and diffuse-type in 37%. Association with autoimmune diseases was observed in 53% of cases, the most common being ulcerative colitis (30%). Serum levels of IgG4 exceeded the upper normal limits (135 mg/dl) in 66% of focal AIP and in 27% of diffuse AIP (P0.006). All patients responded to steroids. At recurrence non-steroid immunosuppressive drugs were successfully used in six patients. Recurrences were observed in 25% of cases, and were more frequent in focal AIP (33%) than in diffuse AIP (12%) (P0.043), in smokers than in non-smokers (41% vs. 15%; P0.011), and in patients with pathological serum levels of IgG4 compared to those with normal serum levels (50% vs. 12%; P0.009). In all, 23% of the patients underwent pancreatic resections. Among patients with focal AIP, recurrences were observed in 30% of operated and in 34% of not operated patients.CONCLUSIONS:Focal-type and diffuse-type AIP differ as regards clinical symptoms and signs. Recurrences occur more frequently in focal AIP than in diffuse AIP. The use of non-steroid immunosuppressants may be a therapeutic option in relapsing AIP.
AB - OBJECTIVES:Autoimmune pancreatitis (AIP) is a particular type of chronic pancreatitis that can be classified into diffuse and focal forms. The aim of this study was to analyze clinical and instrumental features of patients suffering from the diffuse and focal forms of AIP.METHODS:AIP patients diagnosed between 1995-2008 were studied.RESULTS:A total of 87 AIP patients (54 male and 33 female patients, mean age 43.415.3 years) were studied. Focal-type AIP was diagnosed in 63% and diffuse-type in 37%. Association with autoimmune diseases was observed in 53% of cases, the most common being ulcerative colitis (30%). Serum levels of IgG4 exceeded the upper normal limits (135 mg/dl) in 66% of focal AIP and in 27% of diffuse AIP (P0.006). All patients responded to steroids. At recurrence non-steroid immunosuppressive drugs were successfully used in six patients. Recurrences were observed in 25% of cases, and were more frequent in focal AIP (33%) than in diffuse AIP (12%) (P0.043), in smokers than in non-smokers (41% vs. 15%; P0.011), and in patients with pathological serum levels of IgG4 compared to those with normal serum levels (50% vs. 12%; P0.009). In all, 23% of the patients underwent pancreatic resections. Among patients with focal AIP, recurrences were observed in 30% of operated and in 34% of not operated patients.CONCLUSIONS:Focal-type and diffuse-type AIP differ as regards clinical symptoms and signs. Recurrences occur more frequently in focal AIP than in diffuse AIP. The use of non-steroid immunosuppressants may be a therapeutic option in relapsing AIP.
UR - http://www.scopus.com/inward/record.url?scp=69949153831&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=69949153831&partnerID=8YFLogxK
U2 - 10.1038/ajg.2009.327
DO - 10.1038/ajg.2009.327
M3 - Article
C2 - 19568232
AN - SCOPUS:69949153831
VL - 104
SP - 2288
EP - 2294
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 9
ER -