Clinical course of ulcerative colitis patients who develop acute pancreatitis

Kim, Jong Wook; Hwang, Sung Wook; Park, Sang Hyoung; Song, Tae Jun; Kim, Myung–Hwan; Lee, Ho‐Su; Ye, Byong Duk; Yang, Dan; Kim, Kyung‐Jo; Myung, Seung‐Jae; Yang, Suk‐Kyun

doi:10.3748/wjg.v23.i19.3505

Cited by 18 publications

(28 citation statements)

References 46 publications

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“…A low need for escalation therapy was documented over the years, and the colectomy rate was quite low at 4.4% (2 patients) over a mean follow-up time of 55 months from the diagnosis of UC. This frequency was similar to a Korean study (7.3%) with a follow-up of 48 months [ 18 ] but different from French data, which reported a higher rate of colectomy (22%) over a long follow-up (68 months). [ 13 ]…”

Section: Discussionsupporting

confidence: 83%

The features and clinical outcomes of inflammatory bowel disease associated with autoimmune pancreatitis

et al. 2022

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The prevalence of inflammatory bowel disease (IBD) has been described in 5% to 40% of autoimmune pancreatitis (AIP) patients. The aim of our study was to evaluate the prevalence, endoscopic features, and outcome of IBD in association with AIP. A retrospective analysis including all consecutive patients with AIP and a histological diagnosis of IBD from 2010 to 2020 was performed. Demographical data, AIP, and IBD features, as well as clinical course, were recorded. Among 267 AIP patients, 45 were diagnosed with ulcerative colitis (UC) (27 men, mean age 31.6), all with a diagnosis of type 2 AIP. The most frequent presentation of AIP was acute pancreatitis (55.5%). Both diffuse (51.1%) and focal (48.9%) pancreatic involvement were observed. The AIP relapse rate was 11.1% over a mean follow-up of 55 months. In 69% of patients, the interval time between the diagnosis of AIP and UC was <1 year. When UC was present at AIP onset, UC was in clinical remission in 50% of patients. Fecal calprotectin levels, when available, were elevated in 86.6% of these patients. Mostly, mild–moderate pancolitis was initially diagnosed (55.5%). During follow-up, escalation therapy for UC was required in 40% of patients after a mean time of 45 months. Two patients (4.4%) underwent colectomy. The prevalence of UC in AIP patients was 17%. Mild pancolitis with a low rate of colectomy was found. Greater awareness is needed to avoid a delayed diagnosis of UC, and the dosage of fecal calprotectin levels could have a role in this setting.

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Section: Discussionsupporting

confidence: 83%

The features and clinical outcomes of inflammatory bowel disease associated with autoimmune pancreatitis

et al. 2022

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“…A recent European multicenter study reported that the subtype of AIP in 91 individuals with coexisting AIP and IBD (58 UC and 33 Crohn’s disease) was almost all type 2 AIP (89/91, type 2 AIP; 2/91, type 1 AIP) 28. On the other hand, the frequency of AIP in IBD patients is very low in South Korea and Japan; 0.4% each, respectively 17,29. Considering the low prevalence of type 2 AIP with IBD, it may be necessary to narrow down candidate IBD patients for diagnosing type 2 AIP.…”

Section: Discussionmentioning

confidence: 99%

“…In the comparison of magnetic resonance cholangiopancreatography (MRCP) findings, MPD stricture was categorized according to extent and multiplicity as follows: MPD narrowing, when the stricture involved any portion of the MPD regardless of the length; and multifocal type, when the stricture involved ≥ 2 sites with intervening normal-looking MPD 17. Common bile duct (CBD) narrowing was also compared between patients with type 2 AIP and ordinary acute interstitial edematous pancreatitis 5.…”

Section: Methodsmentioning

confidence: 99%

Type 2 Autoimmune Pancreatitis (Idiopathic Duct-Centric Pancreatitis) Highlighting Patients Presenting as Clinical Acute Pancreatitis: A Single-Center Experience

Song

Moon

et al. 2019

Gut and Liver

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Background/Aims Type 2 autoimmune pancreatitis (AIP) has been considered extremely rare in East Asia. This study aimed to clarify the prevalence, clinical characteristics and radiological findings of type 2 AIP highlighting patients presenting as acute pancreatitis in a single center. Methods Type 2 AIP patients were classified according to International Consensus Diagnostic Criteria. Radiological findings were compared between type 2 AIP presenting as acute pancreatitis and gallstone pancreatitis. Results Among 244 patients with AIP, 27 (11.1%) had type 2 AIP (definite, 15 [55.5%] and probable 12 [44.5%]). The median age of patients with type 2 AIP was 29 years (interquartile range, 20 to 39 years). Acute pancreatitis was the most common initial presentation (n=17, 63%) while obstructive jaundice was present in only one patient. Ulcerative colitis (UC) was associated with type 2 AIP in 44.4% (12/27) of patients. Radiological pancreatic imaging such as delayed enhancement of diffusely enlarged pancreas, homogeneous enhancement of focal enlargement/mass, absent/minimal peripancreatic fat infiltration or fluid collection, and multifocal main pancreatic duct narrowings were helpful for differentiating type 2 AIP from gallstone pancreatitis. During follow-up (median, 32.3 months), two patients (2/25, 8%) experienced relapse. Conclusions In South Korea, type 2 AIP is not as rare as previously thought. Overall, the clinical profile of type 2 AIP was similar to that of Western countries. Type 2 AIP should be considered in young UC patients with acute pancreatitis of uncertain etiology.

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“…While the prevalence of IBD in different types of pancreatitis 11–13 and the influence of AIP on the natural disease course of IBD 14 have been described before, whether the presence of IBD influences the natural history of AIP type 2 remains unknown. The present study aims to examine the relationship between AIP type 2 and IBD in patients from two European tertiary care centers and to summarize the existing data in the literature on this topic.…”

Section: Introductionmentioning

confidence: 97%

Unraveling the relationship between autoimmune pancreatitis type 2 and inflammatory bowel disease: Results from two centers and systematic review of the literature

et al. 2022

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Introduction The relationship between autoimmune pancreatitis (AIP) type 2 and inflammatory bowel disease (IBD) has been established and previously described within International Consensus Diagnostic Criteria. However, it is unknown if the presence of IBD changes the natural disease course of AIP type 2. Our aim was to investigate the association between AIP type 2 and IBD as well as to systematically summarize all the existing evidence in the literature. Methods Electronic medical record analysis was conducted in two centers (in Stockholm, Sweden, and Milan, Italy; records dated between January 2001 and June 2021). Additionally, we conducted a systematic review of the literature. Results A total of 35 patients (18 females, 51.4%) fulfilled the diagnostic criteria of AIP type 2 and were included in the study. A diagnosis of IBD was established in 29 patients (82.8%), ulcerative colitis in 17 (58.6%) and Crohn's disease in 11 (37.9%). Median follow‐up was 54 months. AIP patients with IBD commonly presented with abdominal pain and/or acute pancreatitis at diagnosis, the latter was prevailing in concomitant and later IBD onset. These patients more frequently used steroids, but there were no differences in relapse rates. Concomitant onset of IBD was associated with the development of diabetes mellitus. There were no cases of colon or pancreatic malignancy during follow‐up. In our systematic analysis, a total of 693 AIP type 2 patients were included from 24 single‐center retrospective studies and 8 multicenter retrospective studies. A diagnosis of IBD was reported in 330 (47.8%) patients. Relapse rate was 20.0%. Conclusions Clinical and radiological remission of AIP type 2 was high, while the cumulative incidence of relapse is around 20%. Our results show that concomitance of IBD imposes no obvious risk of a different disease course for AIP type 2.

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Clinical course of ulcerative colitis patients who develop acute pancreatitis

Cited by 18 publications

References 46 publications

The features and clinical outcomes of inflammatory bowel disease associated with autoimmune pancreatitis

The features and clinical outcomes of inflammatory bowel disease associated with autoimmune pancreatitis

Type 2 Autoimmune Pancreatitis (Idiopathic Duct-Centric Pancreatitis) Highlighting Patients Presenting as Clinical Acute Pancreatitis: A Single-Center Experience

Unraveling the relationship between autoimmune pancreatitis type 2 and inflammatory bowel disease: Results from two centers and systematic review of the literature

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