Frequency and characteristics of pancreatitis in patients with inflammatory bowel disease

Barthet, Marc; Lesavre, Nathalie; Desplats, S.; Panuel, M.; Gasmi, Mohamed; Bernard, Jean‐Paul; Dagorn, Jean–Charles; Grimaud, Jean–Charles

doi:10.1159/000094564

Cited by 57 publications

(53 citation statements)

References 44 publications

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“…Crohn's disease was underlying in 30% of cases, and another 25% were diagnosed in patients treated for hematological malignancies. Patients with inflammatory bowel disease are at a high risk of drug-induced AP, those with Crohn's disease significantly more so than those suffering from ulcerative colitis [11][12][13][14]. Multiple anti-cancer chemotherapy is another known risk factor for the disease [8].…”

Section: Discussionmentioning

confidence: 99%

Incidence, Severity, and Etiology of Drug-Induced Acute Pancreatitis

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Incidence, Severity, and Etiology of Drug-Induced Acute Pancreatitis

et al. 2010

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“…132,133 Patients with previous episodes of pancreatitis appear more likely to have hyperamylasemia and hyperlipasemia than patients who never had any form of pancreatitis in the past. 134 The clinical significance and utility of the elevation in pancreatic enzymes in asymptomatic patients with IBD warrants further investigation.…”

Section: Acute Pancreatitismentioning

confidence: 99%

“…141 Pancreatic autoantibodies were found in 20% of the patients and did not correlate with evidence of pancreatic insufficiency or pancreatic duct changes on imaging in a recent study. 134 While the relevance of these antibodies to the pathogenesis of IBD-associated pancreatitis is unclear, these antibodies may be secondary to immune dysregulation triggered by bowel inflammation. 142 Future studies on the pathogenesis of pancreatitis and its relationship to the long-term outcome in IBD are required.…”

Section: Chronic Pancreatitismentioning

confidence: 99%

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Hepatopancreatobiliary manifestations and complications associated with inflammatory bowel disease

Navaneethan¹,

Shen²

2010

Inflammatory Bowel Diseases

180

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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“…When compared to the general population the prevalence of IBD in patients with AIP was 10-fold, hence indicating that AIP could be contributing to the clinical finding of IBD-associated pancreatitis [184,185]. Data from a single prospective study of IBD patients with pancreatitis with high serum IgG4 is available and this needs to be further incorporated and validated in future studies.…”

Section: Pancreatitismentioning

confidence: 99%

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

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Disorders of the liver and the biliary tract are frequently the extraintestinal manifestations of inflammatory bowel disease (IBD). The etiology of these hepato-biliary conditions is deemed secondary to their shared pathogenesis, the chronic effects of a long term, ongoing inflammation of the bowels, along with the medications used to manage IBD. For up to 30% of patients with IBD, abnormal liver biochemical tests are present. Other, selected patients with IBD are followed for reactivation of hepatitis B, through guidelines only relatively recently in place. The vast realm of related clinical conditions does not always correspond well with IBD severity, which can range from mild hepatic insult to end-stage liver disease, necessitating liver transplantation. Hence it is critical to follow its presence, clinical course and long term consequences. Moreover, the management of these disorders is necessarily individualized, with some patients requiring frequent monitoring and others a more multi-disciplinary approach. Studies aimed at improving the outcomes of patients with IBD who experience associated liver and biliary tract disorders are now needed to assess early identification, possible screening approaches and more effective systems of referral. This article covers the evidence-based literature on topics detailing the co-existence of liver conditions in inflammatory bowel disease with a focus on its epidemiology, clinical manifestations, diagnosis and management.

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Frequency and characteristics of pancreatitis in patients with inflammatory bowel disease

Cited by 57 publications

References 44 publications

Incidence, Severity, and Etiology of Drug-Induced Acute Pancreatitis

Incidence, Severity, and Etiology of Drug-Induced Acute Pancreatitis

Hepatopancreatobiliary manifestations and complications associated with inflammatory bowel disease

A review of liver disorders in inflammatory bowel disease (IBD)

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