title: Clinical significance of extrapancreatic lesions in autoimmune pancreatitis.
abstract: OBJECTIVE
  To clarify the frequency and clinical significance of extrapancreatic lesions in autoimmune pancreatitis (AIP).
  
  
  METHODS
  The frequency and clinical characteristics of extrapancreatic lesions during the clinical course of AIP were investigated retrospectively in 64 patients with AIP. The predictive factors for relapse of AIP at clinical onset were also examined.
  
  
  RESULTS
  Extrapancreatic lesions occurred in 95% (61/64) during the clinical course of AIP. The frequencies of sclerosing cholangitis, sclerosing sialadenitis, retroperitoneal fibrosis, and mediastinal or hilar lymphadenopathy were 84% (54/64), 23% (15/64), 16% (10/64), and 77% (27/35), respectively. Patients with sclerosing sialadenitis or extrapancreatic bile duct sclerosing cholangitis had a significantly higher serum immunoglobulin G concentration than those without (P = 0.005 and P = 0.016, respectively). Univariate analysis revealed that sclerosing sialadenitis (P = 0.005), diffuse pancreatic ductal changes (P = 0.028), and a high serum immunoglobulin G concentration (P = 0.030) at clinical onset of AIP were significant predictive factors for relapse. Multivariate analysis revealed that diffuse pancreatic ductal changes (P = 0.005) and sclerosing sialadenitis (P = 0.012) were significant independent predictive factors for relapse of AIP.
  
  
  CONCLUSIONS
  The frequency of extrapancreatic lesions with AIP during the clinical course was high. The presence of sclerosing sialadenitis at clinical onset is a significant predictive factor for relapse of AIP.
authors.affiliation: Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Naitoh
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ohara
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ando
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hayashi
authors.forename: Hajime
authors.initials: H
authors.lastname: Tanaka
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Okumura
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miyabe
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sano
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takada
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications / Q000473:pathology*; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016015:Logistic Models; D008206:Lymphatic Diseases / Q000150:complications / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012185:Retroperitoneal Fibrosis / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies; D012793:Sialadenitis / Q000150:complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: D007074:Immunoglobulin G