title: Long-term follow-up of autoimmune pancreatitis: characteristics of chronic disease and recurrence.
abstract: Autoimmune pancreatitis is a unique disease, characterized by lymphoplasmacytic inflammation in the acute stages. However, the active clinical features are unlikely to persist for long periods. Through long-term follow-up, we investigated the disease course in 51 patients with autoimmune pancreatitis. We found recurrence in 21 (41%) patients and pancreatic stone formation in 9 (18%) patients. Pancreatic stone formation was significantly more frequent in the recurrence group (7/21, 33%), compared with the nonrecurrence group (2/30, 7%). Moreover, we found high serum immunoglobulin G4 concentrations in 13 of 175 (7.4%) patients with ordinary chronic pancreatitis. This suggested that pancreatic stone formation is closely associated with recurrence and that autoimmune pancreatitis might transform into ordinary chronic pancreatitis after several recurrences. We found that the immune complex level, with a cutoff value of 10 microg/dL, served as a good predictor of recurrence, with high sensitivity (61.9%), specificity (70.0%), and efficacy (66.7%). We also confirmed that HLA and cytotoxic T-lymphocyte antigen-4 polymorphisms were useful predictors for AIP recurrence.
authors.affiliation: Center for Health, Safety and Environmental Management, Shinshu University, Asahi, Matsumoto, Japan. skawapc@shinshu-u.ac.jp
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hamano
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ito
authors.forename: Ryou
authors.initials: R
authors.lastname: Kodama
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Chou
authors.forename: Mari
authors.initials: M
authors.lastname: Takayama
authors.forename: Norikazu
authors.initials: N
authors.lastname: Arakura
mesh_terms: D000936:Antigen-Antibody Complex / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D015415:Biomarkers; D015704:CD4 Antigens / Q000235:genetics; D002137:Calculi / Q000209:etiology; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D011110:Polymorphism, Genetic; D012008:Recurrence; D012680:Sensitivity and Specificity
chemical_list: D000936:Antigen-Antibody Complex; D015415:Biomarkers; D015704:CD4 Antigens; D006680:HLA Antigens; D007074:Immunoglobulin G