中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 4
Apr.  2021
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(4): 888-892

Clinical features and prognosis of autoimmune pancreatitis alone or with IgG4-related sclerosing cholangitis

DOI: 10.3969/j.issn.1001-5256.2021.04.032

  • Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

  • Received Date: 2020-09-15
  • Accepted Date: 2020-10-29
  • Published Date: 2021-04-20
    Abstract
  •   Objective  To investigate the clinical features, diagnosis, treatment, and prognosis of autoimmune pancreatitis (AIP) alone versus AIP with IgG4 sclerosing cholangitis (IgG4-SC).  Methods  A retrospective analysis was performed for the clinical data of 40 patients with type 1 AIP who were admitted to The First Affiliated Hospital of Zhengzhou University from June 2015 to January 2020, among whom 29 patients had AIP alone and 11 had AIP with IgG4-SC. The two groups were compared in terms of clinical manifestations, laboratory examination, imaging findings, treatment, and prognosis. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Fisher's exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to calculate recurrence rate and plot recurrence curve, and the log-rank test was used for univariate analysis.  Results  Compared with the AIP group, the AIP+IgG4-SC group had significantly higher number of affected organs [3.0(3.0-4.0) vs 3.0(1.5-3.5), Z=-2.172, P=0.035] and response index before treatment [12.0(12.0-15.0) vs 12.0(9.0-13.5), Z=-2.157, P=0.032]. The AIP+IgG4-SC group had a significantly higher median serum IgG level than the AIP group [21.0(15.8-23.7) g/L vs 14.8(13.3-15.7) g/L, Z=-2.711, P=0.004]. During the median follow-up time of 15.8 (6.5-31.3) months, the AIP+IgG4-SC group had a significantly higher recurrence rate than the AIP group (χ2=8.155, P=0.004).  Conclusion  Patients with AIP and IgG4-SC tend to have higher serum IgG4 level, number of affected organs, and recurrence rate than those with AIP alone. Early identification, diagnosis, and treatment can reduce the recurrence rate of AIP.

     

    • FullText(HTML)
  • loading
    • References(22)
  • [1]
    SHIMOSEGAWA T, CHARI ST, FRULLONI L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: Guidelines of the International Association of Pancreatology[J]. Pancreas, 2011, 40(3): 352-358. DOI: 10.1097/MPA.0b013e3182142fd2
    [2]
    BJÖRNSSON E, CHARI ST, SMYRK TC, et al. Immunoglobulin G4 associated cholangitis: Description of an emerging clinical entity based on review of the literature[J]. Hepatology, 2007, 45(6): 1547-1554. DOI: 10.1002/hep.21685
    [3]
    ZHU L, XUE HD, ZHANG W, et al. Pancreaticobiliary involvement in treated type 1 autoimmune pancreatitis: Imaging pattern and risk factors for disease relapse[J]. Eur J Radiol, 2019, 120: 108673. DOI: 10.1016/j.ejrad.2019.108673
    [4]
    NAKAMURA A, OZAWA M, WATANABE T, et al. Predictive factors for autoimmune pancreatitis relapse after 3 years of maintenance therapy[J]. Pancreas, 2018, 47(10): 1337-1343. DOI: 10.1097/MPA.0000000000001173
    [5]
    MIKI M, FUJIMORI N, OONO T, et al. Relapse patterns and predictors of IgG4-related diseases involved with autoimmune pancreatitis: A single-center retrospective study of 115 patients[J]. J Dig Dis, 2019, 20(3): 152-158. DOI: 10.1111/1751-2980.12708
    [6]
    OHARA H, OKAZAKI K, TSUBOUCHI H, et al. Clinical diagnostic criteria of IgG4-related sclerosing cholangitis 2012[J]. J Hepatobiliary Pancreat Sci, 2012, 19(5): 536-542. DOI: 10.1007/s00534-012-0521-y
    [7]
    UMEHARA H, OKAZAKI K, MASAKI Y, et al, Comprehensive diagnostic criteria for IgG4-related disease(IgG4-RD), 2011[J]. Mod Rheumatol, 2012, 22(1): 21-30. DOI: 10.3109/s10165-011-0571-z
    [8]
    CARRUTHERS MN, STONE JH, DESHPANDE V, et al. Development of an IgG4-RD responder index[J]. Int J Rheumatol, 2012, 2012: 259408.
    [9]
    KHANDELWAL A, INOUE D, TAKAHASHI N. Autoimmune pancreatitis: An update[J]. Abdom Radiol (NY), 2020, 45(5): 1359-1370. DOI: 10.1007/s00261-019-02275-x
    [10]
    KAMISAWA T, NAKAZAWA T, TAZUMA S, et al. Clinical practice guidelines for IgG4-related sclerosing cholangitis[J]. J Hepatobiliary Pancreat Sci, 2019, 26(1): 9-42. DOI: 10.1002/jhbp.596
    [11]
    OKAZAKI K, CHARI ST, FRULLONI L, et al. International consensus for the treatment of autoimmune pancreatitis[J]. Pancreatology, 2017, 17(1): 1-6. DOI: 10.1016/j.pan.2016.12.003
    [12]
    MASAMUNE A, KIKUTA K, HAMADA S, et al. Nationwide epidemiological survey of autoimmune pancreatitis in Japan in 2016[J]. J Gastroenterol, 2020, 55(4): 462-470. DOI: 10.1007/s00535-019-01658-7
    [13]
    LI MZ, YANG AM. IgG4-related autoimmune pancreatitis and diabetes mellitus[J]. Chin J Pancreatol, 2019, 19(6): 475-477. (in Chinese) DOI: 10.3760/cma.j.issn.1674-1935.2019.06.021

    李美姿, 杨爱明. IgG4相关性自身免疫性胰腺炎与糖尿病[J]. 中华胰腺病杂志, 2019, 19(6): 475-477. DOI: 10.3760/cma.j.issn.1674-1935.2019.06.021
    [14]
    OKAZAKI K, UCHIDA K. Current perspectives on autoimmune pancreatitis and IgG4-related disease[J]. Proc Jpn Acad Ser B Phys Biol Sci, 2018, 94(10): 412-427. DOI: 10.2183/pjab.94.027
    [15]
    LV H, LIU A, ZHAO Y, et al. Comparison of clinical characteristics of radiological forms of autoimmune pancreatitis[J]. HPB (Oxford), 2018, 20(11): 1021-1027. DOI: 10.1016/j.hpb.2018.04.009
    [16]
    JIANG XH, HU NZ, CHEN LH. Immunoglobulin G4 in differentiating autoimmune pancreatitis from pancreatic cancer: A systemic review and meta-analysis[J]. Chin J Pancreatol, 2016, 16(2): 119-123. (in Chinese) DOI: 10.3760/cma.j.issn.1674-1935.2016.02.010

    蒋晓涵, 胡乃中, 陈丽红. 免疫球蛋白G4鉴别诊断自身免疫性胰腺炎与胰腺癌价值的荟萃分析[J]. 中华胰腺病杂志, 2016, 16(2): 119-123. DOI: 10.3760/cma.j.issn.1674-1935.2016.02.010
    [17]
    TANAKA A, TAZUMA S, OKAZAKI K, et al. Clinical features, response to treatment, and outcomes of IgG4-related sclerosing cholangitis[J]. Clin Gastroenterol Hepatol, 2017, 15(6): 920-926.e3. DOI: 10.1016/j.cgh.2016.12.038
    [18]
    KAMISAWA T, NAKAZAWA T, TAZUMA S, et al. Clinical practice guidelines for IgG4-related sclerosing cholangitis[J]. J Hepatobiliary Pancreat Sci, 2019, 26(1): 9-42. DOI: 10.1002/jhbp.596
    [19]
    MIAO F, CHEN FY. Imaging diagnosis of autoimmune pancreatitis[J]. J Clin Hepatol, 2018, 34(8): 1604-1608. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2018.08.003

    缪飞, 陈芳莹. 自身免疫性胰腺炎的影像学诊断[J]. 临床肝胆病杂志, 2018, 34(8): 1604-1608. DOI: 10.3969/j.issn.1001-5256.2018.08.003
    [20]
    LIU L, CHEN Y, HUANG ZW, et al. Clinical value of CT enhanced imaging combined with serum IgG4 and CA199 detection in differential diagnosis of autoimmune pancreatitis[J]. Chin J Immunol, 2019, 35(22): 2769-2773. (in Chinese) DOI: 10.3969/j.issn.1000-484X.2019.22.016

    刘兰, 陈跃, 黄占文, 等. CT增强影像学联合血清IgG4和CA199检测在自身免疫性胰腺炎鉴别诊断中的临床价值[J]. 中国免疫学杂志, 2019, 35(22): 2769-2773. DOI: 10.3969/j.issn.1000-484X.2019.22.016
    [21]
    HART PA, KAMISAWA T, BRUGGE WR, et al. Long-term outcomes of autoimmune pancreatitis: A multicentre, international analysis[J]. Gut, 2013, 62(12): 1771-1776. DOI: 10.1136/gutjnl-2012-303617
    [22]
    TACELLI M, CELSA C, MAGRO B, et al. Risk factors for rate of relapse and effects of steroid maintenance therapy in patients with autoimmune pancreatitis: Systematic review and Meta-analysis[J]. Clin Gastroenterol Hepatol, 2019, 17(6): 1061-1072.e8. DOI: 10.1016/j.cgh.2018.09.051
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (512) PDF downloads(34) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return