Autoimmune Pancreatitis and Inflammatory Bowel Disease

Abstract

Autoimmune pancreatitis (AIP) occurring in association with inflammatory bowel disease (IBD) is rather rare and carries a worse prognosis and greater disease severity compared with IBD alone. Although it is an infrequently documented association, progress over the last 20 years has led to better understanding of the association between AIP and IBD. IBD has a stronger association with type 2 than with type 1 AIP. Clinical and histologic features of AIP-IBD more often reveal features of type 2 AIP. Imaging is not helpful in facilitating the diagnosis of AIP and IBD. Similarly, attempts to identify a serological marker have not yielded better result. A proposed lymphocyte homing mechanism provides some insight into the mechanism of pathogenesis. This review represents an update of our current knowledge of the association between AIP and IBD.

Gastrointestinal motility and absorptive disorders in patients with inflammatory bowel diseases: Prevalence, diagnosis and treatment

“…The risk was higher in patients with more than three bowel movements per day[22]. Although uncommon, type-2 autoimmune pancreatitis has been also associated with IBD, which can lead to exocrine insufficiency[23]. According to the International Consensus Diagnostic Criteria the diagnosis is based on imaging findings such as enlargement of the pancreas or narrowing of the main pancreatic duct, the presence of granulocyte epithelial lesions in histology, frequent association with extra-pancreatic involvement and considerable response to steroids.…”

Missing in action—The meaning of cell death in tissue damage and inflammation

“…The pathophysiological chain of events in this model most closely resembles findings from the rare human disease autoimmune pancreatitis type 2, which is characterized by pathognomonic granulocytic epithelial lesions . This disease is typically associated with chronic inflammatory states like ulcerative colitis and responds readily to corticosteroid therapy …”

Pancreatic diseases and inflammatory bowel diseases: a random or regular combination?

“…АИП является редким заболеванием ПЖЖ, он характеризуется часто рецидивирующей механической желтухой, с сопутствующей «опухолью» ПЖЖ или без нее и хорошим ответом на терапию ГКС. Гистологически АИП проявляется лимфоплазмацитарной инфильтрацией и фиброзом ПЖЖ [31,32]. Выделяют два типа АИП: тип 1 и тип 2; ВЗК, по-видимому, связан с обеими формами, но в большей степени с AИП типа 2 [32].…”

“…Гистологически АИП проявляется лимфоплазмацитарной инфильтрацией и фиброзом ПЖЖ [31,32]. Выделяют два типа АИП: тип 1 и тип 2; ВЗК, по-видимому, связан с обеими формами, но в большей степени с AИП типа 2 [32]. Так, по данным международного многоцентрового исследования, среди 64 пациентов с АИП типа 2 распространенность ЯК и БК составила 16 и 1% соответственно, тогда как в группе 153 пациентов с АИП тип 1 -1% в целом [33].…”