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Grandval, Philippe; Barthet, Marc; Desjeux, Ariadne; Garcia, Stéphane; Boustière, Christian; Poilroux, Bernard; Grimaud, Jean–Charles

doi:10.1023/a:1010733308228

Cited by 14 publications

(1 citation statement)

References 17 publications

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“…Though the mechanisms of pancreatitis as an extraintestinal complication of UC remain unclear, there are some reports that have suggested possible mechanisms: malnutrition in UC, activation of trypsinogen due to intestinal bacteria, existence of a local circulatory disorder due to stimulation of the sympathetic nervous system, stimulation in cavities around the pancreatic acinus by proteases and cytokines derived from the colon mucosa via the portal lymphatic system, and exocrine disorders associated with an increase in the viscosity of pancreatic juice due to intestinal paralysis or dehydration [4, 5, 6]. On the other hand, UC may be associated with autoimmune pancreatitis from the consideration of autoimmune disease [7] and involvement of anti-carbonic anhydrase II antibody [8]. The occurrence of autoimmune pancreatitis is known to be strongly related to the disease activity of UC.…”

Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis due to pH-Dependent Mesalazine That Occurred in the Course of Ulcerative Colitis

Arai

Arihiro²,

Ichikawa³

et al. 2011

Case Rep Gastroenterol

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We report the case of a 26-year-old male who presented with acute pancreatitis during the course of treatment for pancolitic ulcerative colitis (UC) with a time-dependent mesalazine formulation, prednisolone and azathioprine (AZA). Despite a review of his clinical history and various tests, the cause of pancreatitis could not be determined. Since drug-induced pancreatitis was considered possible, administration of the time-dependent mesalazine preparation and AZA was discontinued, and conservative treatment for acute pancreatitis was performed. The pancreatitis promptly improved with these treatments, but drug lymphocyte stimulation test (DLST) for both the time-dependent mesalazine formulation and AZA was negative. A pH-dependent mesalazine formulation was given for maintenance therapy of UC. Subsequently, as the pancreatitis relapsed, drug-induced pancreatitis was strongly suspected. Administration of mesalazine was discontinued, and pancreatitis was smoothly in remission by conservative treatment. According to the positive DLST result for the pH-dependent mesalazine formulation and the clinical course, a diagnosis of pH-dependent mesalazine-induced pancreatitis due to this formulation was made. During the clinical course of UC, occurrence of drug-induced pancreatitis must always be considered.

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Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis due to pH-Dependent Mesalazine That Occurred in the Course of Ulcerative Colitis

Arai

Arihiro²,

Ichikawa³

et al. 2011

Case Rep Gastroenterol

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Hepatopancreatobiliary manifestations and complications associated with inflammatory bowel disease

Navaneethan¹,

Shen²

2010

Inflammatory Bowel Diseases

181

127

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Diseases involving the hepatopancreatobiliary (HPB) system are frequently encountered in patients with inflammatory bowel disease (IBD). Hepatobiliary manifestations constitute some of the most common extraintestinal manifestations of IBD. They appear to occur with similar frequency in patients with Crohn's disease or ulcerative colitis. HPB manifestations may occur in following settings: 1) disease possibly associated with a shared pathogenetic mechanism with IBD including primary sclerosing cholangitis (PSC), small-duct PSC/pericholangitis and PSC/autoimmune hepatitis overlap, acute and chronic pancreatitis related to IBD; 2) diseases which parallel structural and physiological changes seen with IBD, including cholelithiasis, portal vein thrombosis, and hepatic abscess; and 3) diseases related to adverse effects associated with treatment of IBD, including drug-induced hepatitis, pancreatitis (purine-based agents), or liver cirrhosis (methotrexate), and reactivation of hepatitis B, and biologic agent-associated hepatosplenic lymphoma. Less common HPB manifestations that have been described in association with IBD include autoimmune pancreatitis (AIP), IgG4-associated cholangitis (IAC), primary biliary cirrhosis (PBC), fatty liver, granulomatous hepatitis, and amyloidosis. PSC is the most significant hepatobiliary manifestation associated with IBD and poses substantial challenges in management requiring a multidisciplinary approach. The natural disease course of PSC may progress to cirrhosis and ultimately require liver transplantation in spite of total proctocolectomy with ileal-pouch anal anastomosis. The association between AIP, IAC, and elevated serum IgG4 in patients with PSC is intriguing. The recently reported association between IAC and IBD may open the door to investigate these complex disorders. Further studies are warranted to help understand the pathogenesis of HPB manifestations associated with IBD, which would help clinicians better manage these patients. An interdisciplinary approach, involving gastroenterologists, hepatologists, and, in advanced cases, general, colorectal, and transplant surgeons is advocated.

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Extraintestinale Manifestationen bei chronischentz�ndlichen Darmerkrankungen*

Rogler

Schölmerich²

2004

coloproctology

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ZusammenfassungExtraintestinale Manifestationen von Morbus Crohn und Colitis ulcerosa finden sich bei mehr als der Hälfte aller Patienten und können belastender als die Grunderkrankung selbst sein. Extraintestinale Manifestationen müssen von Sekundärerkrankungen oder Folgen der chronisch-entzündlichen Darmerkrankungen (CED) unterschieden werden, da sie einer anderen Therapie bedürfen. Während Krankheitsfolgen wie Vitaminmangelzustände oder Osteoporose durch Vitaminsubstitution oder Calciumund Vitamin-D-Gabe spezifisch therapierbar sind, ist die Therapie extraintestinaler Manifestationen von CED wie der primär sklerosierenden Cholangitis, der sog. Typ-II-Arthritis oder granulomatöser Entzündungen der Haut, Leber oder Lunge häufig deutlich schwieriger und komplexer. Extraintestinale Symptome des Morbus Crohn und der Colitis ulcerosa können sich an nahezu jedem Organ manifestieren. Es ist wichtig, diese extraintestinalen Manifestationen der CED zu kennen, um einerseits rechtzeitig und frühzeitig Therapiemaßnahmen einleiten zu können.Andererseits können extraintestinale Symptome die Primärmanifestation eines Morbus Crohn und seltener einer Colitis ulcerosa darstellen. Sie müssen dann als solche erkannt werden, um die Betroffenen frühzeitig adäquat therapieren zu können. Schlüsselwörter: Chronisch-entzündliche Darmerkrankungen · Morbus Crohn · Colitis ulcerosa · Extraintestinale Manifestationen SummaryExtraintestinal manifestations of Crohn's disease and ulcerative colitis are found in > 50% of all patients.These extraintestinal manifestations sometimes impair the overall life quality much more than the bowel-related symptoms. Extraintestinal manifestations need to be distinguished from secondary diseases or complications of inflam-coloproctology coloproctology 2004;26:152-62

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Cited by 14 publications

References 17 publications

Acute Pancreatitis due to pH-Dependent Mesalazine That Occurred in the Course of Ulcerative Colitis

Acute Pancreatitis due to pH-Dependent Mesalazine That Occurred in the Course of Ulcerative Colitis

Hepatopancreatobiliary manifestations and complications associated with inflammatory bowel disease

Extraintestinale Manifestationen bei chronischentz�ndlichen Darmerkrankungen*

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