Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation.
OBJECTIVE
Autoimmune pancreatitis has been characterized by irregular narrowing of the main pancreatic duct and sonolucent swelling of the parenchyma, both of which are due to lymphoplasmacytic inflammation at the active stage of the disease, and by the absence of pancreatic stone formation. The aim of the present study was to confirm or deny whether or not this disease is progressive with recurrent attacks, resulting in pancreatic stone formation like ordinary chronic pancreatitis.


METHODS
Forty-two patients, 36 of whom were treated with prednisolone, were followed up for periods longer than 12 months (median follow-up period: 54.5 months, range: 13-111 months) by regular interview and examination of their medical records for laboratory tests and image tests.


RESULTS
Eleven patients (26.2%) who were treated with prednisolone showed recurrent attacks during median follow-up periods of 22 months. Eight patients (19%) showed the formation of pancreatic stones during the follow-up periods. Because 6 of 11 patients (54.5%) who suffered relapse showed pancreatic stone formation, it is significantly associated with relapse in comparison with nonrelapse (p= 0.0019).


CONCLUSIONS
Contrary to previous reports, we observed both relapse and pancreatic stone formation in some patients with autoimmune pancreatitis, which suggests that autoimmune pancreatitis has the potential to be a progressive disease with pancreatic stones.
Takayama
Mari
M
Department of Medicine, Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
Hamano
Hideaki
H
Ochi
Yasuhide
Y
Saegusa
Hisanobu
H
Komatsu
Kenichi
K
Muraki
Takashi
T
Arakura
Norikazu
N
Imai
Yasuharu
Y
Hasebe
Osamu
O
Kawa
Shigeyuki
S
D000368:Aged; D001327:Autoimmune Diseases; D002137:Calculi / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology*; D010195:Pancreatitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology*; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed