Introduction
Autoimmune pancreatitis and pancreatic calcification
Development of pancreatic calcification
Epidemiology of pancreatic calcification
Predictors of relapse
Risk factors for pancreatic stone formation
Stone-forming | Non-stone-forming | P value | |
---|---|---|---|
group (n = 28) | group (n = 32) | ||
Clinical features | Median (range) | ||
Observation period§ | 100 (36–165) | 90 (36–230) | 0.524 |
Age | 67 (47–84) | 64.5 (38–81) | 0.543 |
Sex (M/F) | 24/4 | 22/10 | 0.140 |
Alcohol (+/−) | 20/8 | 19/12 | 0.582 |
Prednisolone (+/−) | 25/3 | 28/4 | 1.000 |
Relapse (+/−) | 11/17 | 6/26 | 0.093 |
Laboratory tests | |||
Amylase | 94 (17–431) | 86 (22–478) | 0.678 |
IgG | 2187 (892–7236) | 2183 (1194–5545) | 0.686 |
IgG4 | 640 (154–2855) | 424 (4–2970) | 0.916 |
C3 | 91 (33–157) | 87 (29–199) | 0.538 |
C4 | 20.1 (7.7–39.7) | 21.3 (1.1–38.7) | 0.627 |
sIL2-R | 738 (132–2260) | 940 (257–4695) | 0.130 |
CIC | 5.1 (1.9–40) | 5.5 (1.9–27.5) | 0.392 |
Pancreatic morphology at diagnosis | |||
Pancreatic swelling (by CT) | |||
Head (+/−) | 26/2 | 20/12 | 0.006* |
Body (+/−) | 20/8 | 19/13 | 0.419 |
Tail (+/−) | 17/11 | 19/13 | 1.000 |
Focal/Segmental-Diffuse | 7/21 | 12/20 | 0.406 |
Ductal narrowing in MPD (by ERP) | |||
Head (+/−) | 24/4 | 22/10 | 0.140 |
Wirsung + Santorini (+/−) | 21/7 | 13/19 | 0.010* |
Body (+/−) | 15/13 | 19/13 | 0.795 |
Tail (+/−) | 22/6 | 24/8 | 0.770 |
Focal/Segmental-Diffuse | 6/22 | 11/21 | 0.390 |
Pancreatic stone formation and pancreatic function: long-term outcomes
Autoimmune pancreatitis can progress to chronic pancreatitis
Serum levels of IgG4 in patients with confirmed chronic pancreatitis
Autoimmune pancreatitis can progress to chronic pancreatitis that meets the revised japanese clinical diagnostic criteria for ordinary chronic pancreatitis
Findings of definite chronic pancreatitis (n = 15) | Number |
---|---|
a. Stones in pancreatic ducts | 9 |
b. Multiple or numerous calcifications distributed in the entire pancreas | 13 |
c. Irregular dilatation of the MPD and irregular dilatation of pancreatic duct branches of variable intensity with scattered distribution throughout the entire pancreas on ERCP | 2 |
d. Irregular dilatation of the MPD and branches proximal to complete or incomplete obstruction of the MPD (with pancreatic stones or protein plugs) on ERCP | 2 |
Findings of probable chronic pancreatitis (n = 1) | |
b. Irregular dilatation of pancreatic duct branches of variable intensity with scattered distribution throughout the entire pancreas, irregular dilatation of the MPD alone, or protein plugs on ERCP | 1 |
c. Irregular dilatation of the MPD throughout the entire pancreas plus pancreatic deformity with irregular contour on CT | 0 |
Clinical features of autoimmune pancreatitis that meet the revised japanese clinical diagnostic criteria for ordinary chronic pancreatitis: risk factors for progression to chronic pancreatitis
Progression to CP | Non-progression to CP | P value | |
---|---|---|---|
(n = 16) | (n = 57) | ||
Clinical features | Median (range) | ||
Observation period§ | 102 (37–165) | 87 (36–230) | 0.522 |
Age | 66.5 (48–75) | 65 (38–84) | 0.989 |
Gender (M/F) | 13/3 | 43/14 | 0.748 |
Alcohol (+/−) | 6/10 | 29/28 | 0.405 |
PSL (+/−) | 13/3 | 50/7 | 0.681 |
PSL maintenance therapy (+/−) | 10/6 | 41/16 | 0.542 |
Relapse (+/−) | 8/8 | 12/45 | 0.030
*
|
Laboratory tests | |||
IgG | 2140 (1166–3861) | 2227 (892–7236) | 0.509 |
IgG4 | 421 (146–1845) | 663 (4–2970) | 0.267 |
C3 | 100 (52–122) | 98 (29–218) | 0.551 |
C4 | 21.8 (12.4–37.7) | 21.1 (1.1–47.3) | 0.495 |
sIL2-R | 726 (132–1845) | 892 (257–4695) | 0.053 |
CIC | 5 (1.9–13.9) | 5.7 (1.4–40) | 0.219 |
Pancreatic morphology at diagnosis | |||
Pancreatic swelling (by CT) | |||
Head (+/−) | 15/1 | 41/16 | 0.096 |
Body (+/−) | 12/4 | 36/21 | 0.553 |
Tail (+/−) | 10/6 | 37/20 | 1.000 |
Level 1/Level 2Φ | 8/8 | 30/27 | 1.000 |
Ductal narrowing in MPD (by ERP) | |||
Head (+/−) | 13/3 | 44/13 | 1.000 |
Wirsung & Santorini (+/−) | 11/5 | 34/23 | 0.573 |
Body (+/−) | 3/13 | 37/20 | 0.001
*
|
Tail (+/−) | 12/4 | 42/15 | 1.000 |
Level 1/Level 2Ψ | 6/10 | 17/40 | 0.558 |
Ductal dilatation in MPD (+/−) | 9/7 | 7/50 | 0.001
*
|