Exocrine and Endocrine Pancreatic Function in 21 Patients Suffering from Autoimmune Pancreatitis before and after Steroid Treatment

Frulloni, Luca; Scattolini, C.; Katsotourchi, A.; Amodio, Antonio; Gabbrielli, Armando; Zamboni, Giuseppe; Benini, Luigi; Vantini, Italo

doi:10.1159/000265945

Cited by 47 publications

(28 citation statements)

References 24 publications

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“…Some cases of AIP have been reported in the literature showing spontaneous clinical and radiological remission without steroid therapy. 23 Since response to steroid treatment is included as cardinal feature, some AIP cases with spontaneous resolution may be misclassified by the ICDC. In such patients, histology obtained by core needle biopsy may be needed for the diagnosis of AIP.…”

Section: Discussionmentioning

confidence: 99%

Application of international consensus diagnostic criteria to an Italian series of autoimmune pancreatitis

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Application of international consensus diagnostic criteria to an Italian series of autoimmune pancreatitis

et al. 2013

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“…Autoimmunity is suspected to be its pathogenesis (Yoshida et al, 1995). Severe exocrine insufficiency has been reported in most of the cases (Ito et al, 2007; Frulloni et al, 2010; Ko et al, 2010). Steroid therapy improves the swelling of the gland and narrowing of the main pancreatic ducts, and reduces serum gamma globulin and immunoglobulin G subtype 4 (IgG4) levels.…”

Section: Steroid Therapy Normalizes Cytoplasmic Mislocalization Of Cfmentioning

confidence: 99%

Molecular Mechanisms of Pancreatic Stone Formation in Chronic Pancreatitis

Ko¹,

Azuma²,

Yoshikawa³

et al. 2012

Front. Physio.

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Chronic pancreatitis (CP) is a progressive inflammatory disease in which the pancreatic secretory parenchyma is destroyed and replaced by fibrosis. The presence of intraductal pancreatic stone(s) is important for the diagnosis of CP; however, the precise molecular mechanisms of pancreatic stone formation in CP were left largely unknown. Cystic fibrosis transmembrane conductance regulator (CFTR) is a chloride channel expressed in the apical plasma membrane of pancreatic duct cells and plays a central role in HCO3- secretion. In previous studies, we have found that CFTR is largely mislocalized to the cytoplasm of pancreatic duct cells in all forms of CP and corticosteroids normalizes the localization of CFTR to the proper apical membrane at least in autoimmune pancreatitis. From these observations, we could conclude that the mislocalization of CFTR is a cause of protein plug formation in CP, subsequently resulting in pancreatic stone formation. Considering our observation that the mislocalization of CFTR also occurs in alcoholic or idiopathic CP, it is very likely that these pathological conditions can also be treated by corticosteroids, thereby preventing pancreatic stone formation in these patients. Further studies are definitely required to clarify these fundamental issues.

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“…DM also improves after steroid therapy in some cases. Although there are some published reports on the short-term effect of steroid therapy on the course of DM,3-9 the long-term outcome of DM after steroid therapy in AIP patients remains unknown. This study aimed to compare the course of the two different onset types of DM in AIP patients after steroid therapy and clarify its long-term outcome.…”

Section: Introductionmentioning

confidence: 99%

Short and Long-Term Outcomes of Diabetes Mellitus in Patients with Autoimmune Pancreatitis after Steroid Therapy

Miyamoto

Kamisawa

Tabata³

et al. 2012

Gut Liver

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Background/AimsAutoimmune pancreatitis (AIP) is frequently associated with diabetes mellitus (DM). This study evaluated the effect of steroid therapy on the course of DM in AIP.MethodsGlucose tolerance was examined in 69 patients with AIP. DM onset was classified as either a simultaneous onset with AIP or an exacerbation of pre-existing DM. Based on the changes in the HbA1c levels and insulin dose, the responses of DM to steroids were classified as improved, no change, or worsened.ResultsThirty (46%) patients were diagnosed as having DM (simultaneous onset, n=17; pre-existing, n=13). Three months after starting the steroid treatment, the DM improved in 13 (54%) of 24 DM patients. The DM improved in 55%, had no change in 36%, and worsened in 9% of the 11 simultaneous onset DM patients, and it improved in 54%, had no change in 31%, and worsened in 15% of the 13 pre-existing DM patients. At approximately 3 years after starting the steroid treatment, the DM improved in 10 (63%) of 16 patients. The pancreatic exocrine function improved in parallel with the changes in the DM in seven patients.ConclusionsBecause approximately 60% of DM associated with AIP is responsive to steroids in the short- and long-terms, marked DM associated with AIP appears to be an indication for steroid therapy.

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Exocrine and Endocrine Pancreatic Function in 21 Patients Suffering from Autoimmune Pancreatitis before and after Steroid Treatment

Cited by 47 publications

References 24 publications

Application of international consensus diagnostic criteria to an Italian series of autoimmune pancreatitis

Application of international consensus diagnostic criteria to an Italian series of autoimmune pancreatitis

Molecular Mechanisms of Pancreatic Stone Formation in Chronic Pancreatitis

Short and Long-Term Outcomes of Diabetes Mellitus in Patients with Autoimmune Pancreatitis after Steroid Therapy

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