title: Highly active state of autoimmune pancreatitis with mikulicz disease.
abstract: OBJECTIVE
  Patients with autoimmune pancreatitis (AIP) sometimes present with Mikulicz disease (MD); however, the clinical features regarding these AIP patients with MD have not yet been fully elucidated. Our aim is to study the clinical differences between AIP with and without MD.
  
  
  METHODS
  Twenty-eight AIP patients were divided into 2 groups, one with MD and one without it. The following factors having a possible association with the presence or absence of MD were investigated: sex; serum IgG and IgG4 levels; the presence or absence of antinuclear autoantibodies, jaundice, diabetes mellitus, swollen duodenal papilla, diffuse pancreatic swelling, spontaneous remission, and relapse.
  
  
  RESULTS
  The MD and non-MD groups consisted of 5 AIP and 23 AIP patients, respectively. The results of univariate analysis revealed that AIP patients presenting with MD were significantly associated with a younger onset, female predominance, high serum IgG4 titer, and diffuse pancreatic swelling (P < 0.05). In 4 of the MD patients, onset preceded pancreatitis.
  
  
  CONCLUSIONS
  Autoimmune pancreatitis patients presenting with MD tended to have different clinical features from the non-MD AIP patients, such as having an earlier onset, female tendency, and diffuse pancreatic swelling with a high titer of serum IgG4. Autoimmune pancreatitis with MD tended to precede gastroenterological events.
authors.affiliation: Division of Gastroenterology,Yokohama City University, Graduate School of Medicine, Yokohama, Japan. kubotak@yokohama-cu.ac.jp
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Tomoko
authors.initials: T
authors.lastname: Wada
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mozaki
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Koji
authors.initials: K
authors.lastname: Fujita
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kirikoshi
authors.forename: Satoru
authors.initials: S
authors.lastname: Saito
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inayama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D008882:Mikulicz' Disease / Q000150:complications*; D010179:Pancreas / Q000473:pathology; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000473:pathology*; D012737:Sex Factors
chemical_list: D000974:Antibodies, Antinuclear; D007074:Immunoglobulin G