title: Biliary lesions associated with autoimmune pancreatitis.
abstract: OBJECTIVE
  Characteristic radiological features of biliary lesions in patients with autoimmune pancreatitis (AIP) have not yet been identified.
  
  
  METHODS
  Bile duct lesions and their relationships to other clinical findings were assessed in 43 AIP patients.
  
  
  RESULTS
  Of the 43 AIP patients, 34 (79%) had bile duct stenosis. In all the 34 patients, the lower bile duct was involved; in 21 of these, only the lower bile duct was involved, and in 13 patients, there was widespread wall thickening of the middle and upper bile duct where stenosis was not obvious on cholangiography. Furthermore, 4 patients with extensive bile duct involvement also had stenosis of the intrahepatic bile duct. All patients with bile duct involvement had involvement of the head portion of the main pancreatic duct. None of the 6 patients with involvement of only the body and/or tail portion of the main pancreatic duct had bile duct involvement. Gallbladder wall thickening was more frequently noted in patients with extensive bile duct involvement (p < 0.01). Serum IgG4 levels were significantly more elevated in patients with extensive bile duct involvement (p < 0.05).
  
  
  CONCLUSIONS
  AIP patients with extensive bile duct involvement characterized by widespread wall thickening of the bile duct may have more active disease.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. kamisawa@cick.jp
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Takuma
authors.forename: Hajime
authors.initials: H
authors.lastname: Anjiki
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
authors.forename: Masanao
authors.initials: M
authors.lastname: Kurata
authors.forename: Goro
authors.initials: G
authors.lastname: Honda
authors.forename: Kouji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Atsutake
authors.initials: A
authors.lastname: Okamoto
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications* / Q000473:pathology; D001660:Biliary Tract Diseases / Q000150:complications* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000473:pathology; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric; D014463:Ultrasonography
chemical_list: D007074:Immunoglobulin G