The Long-Term Impact of Autoimmune Pancreatitis on Pancreatic Function, Quality of Life, and Life Expectancy.
OBJECTIVE
To evaluate the long-term outcome of autoimmune pancreatitis.


METHODS
Patients with at least 2 years of follow-up were included. Information was collected regarding disease characteristics, treatment outcome, diagnosed malignancies, and mortality. In addition, pancreatic function and quality of life were assessed prospectively.


RESULTS
107 patients were included (87% men, 90% with type 1), with a median follow-up of 74 (interquartile range, 49-108) months. One third was operated for suspected pancreatic cancer (32%). Most patients were (successfully) treated with steroids (83%), but relapses were common (52%), for which no risk factors could be identified. Pancreatic carcinoma was not observed.Prospective data were obtained from 64%, as 17% had died, 7% were lost to follow-up, and 13% refused to participate. After a median of 75 (interquartile range, 50-106) months, 46% still used active treatment. Exocrine and endocrine insufficiencies were highly prevalent (82% and 57%, respectively). Quality of life and survival were not impaired, as compared with a reference population.


CONCLUSIONS
Despite an excellent initial treatment response, relapses are common, even in type 2, and almost half of the patients require maintenance therapy. Pancreatic insufficiency is highly prevalent, which calls for active screening. Pancreatic cancer was not observed, and quality of life and survival are not impaired.
From the*Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam; †Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam; Departments of ‡Public Health and §Pathology, Erasmus University Medical Center, Rotterdam; ∥Department of Pathology, Academic Medical Center Amsterdam, Amsterdam; ¶Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht; and #Department of Gastroenterology, Meander Medical Center, Amersfoort, The Netherlands.
Jorie
J
Buijs
Djuna L
DL
Cahen
Marianne J
MJ
van Heerde
Erik A
EA
Rauws
Lucas J Maillette
LJ
de Buy Wenniger
Bettina E
BE
Hansen
Katharina
K
Biermann
Joanne
J
Verheij
Frank P
FP
Vleggaar
Menno A
MA
Brink
Ulrich H W
UH
Beuers
Henk R
HR
van Buuren
Marco J
MJ
Bruno
D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008017:Life Expectancy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010186:Pancreatic Function Tests; D010195:Pancreatitis / Q000503:physiopathology / Q000628:therapy*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors