Risk factors for pancreatic stone formation in autoimmune pancreatitis over a long-term course

Maruyama, Masahiro; Arakura, Norikazu; Ozaki, Yayoi; Watanabe, Takayuki; Ito, Tetsuya; Yoneda, Suguru; Maruyama, Masafumi; Muraki, Takamura; Hamano, Hideaki; Matsumoto, Akihiro; Kawa, Shigeyuki

doi:10.1007/s00535-011-0510-y

Cited by 46 publications

(46 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multivariate analysis identified narrowing of both Wirsung’s and Santorini’s ducts as a significant independent risk factor for pancreatic stone formation (OR 4.4, p = 0.019). Even after corticosteroid therapy, residual pancreatic head swelling and/or narrowing of Wirsung’s and Santorini’s ducts were more frequently found in stone-forming patients in our cohort [41]. These results supported the notion that narrowing of Wirsung’s and Santorini’s ducts in the pancreatic head region led to pancreatic juice stasis and eventual stone formation.…”

Section: Autoimmune Pancreatitis and Pancreatic Calcificationsupporting

confidence: 86%

“…The main reason for a presumed association between calcification and relapse may be attributed to recurrent periductal lymphoplasmacytic inflammation, which is a characteristic pathological feature of type 1 AIP [17], that leads to remnant pancreatic duct stricture resulting in pancreatic juice stasis and intraductal calcification. Indeed, our later studies disclosed that pancreatic calcification was significantly associated with pancreatic head swelling and narrowing of both Wirsung’s and Santorini’s ducts in the pancreatic head region [41]. Recurrent parenchymal inflammation with ensuing calcification may also be a contributive factor in AIP relapse.…”

Section: Autoimmune Pancreatitis and Pancreatic Calcificationmentioning

confidence: 99%

“…The frequency of pancreatic calcification in AIP ranges from 4% to 40% [14,29,30,32,34-36,38,41,42]. Hart et al conducted an international investigation on AIP and reported that 46 of 659 patients (7%) demonstrated this condition.…”

Section: Autoimmune Pancreatitis and Pancreatic Calcificationmentioning

confidence: 99%

“…To examine the risk factors underlying pancreatic stone formation in AIP, we enrolled 69 AIP patients who had been followed for at least 3 years (median follow-up period: 91 months, range: 36–230 months) [41]. During the study period, increased or de novo stone formation was seen in 28 patients (28/69, 40.6%), who were defined as the stone-forming group.…”

Section: Autoimmune Pancreatitis and Pancreatic Calcificationmentioning

confidence: 99%

See 3 more Smart Citations

Autoimmune pancreatitis can develop into chronic pancreatitis

Maruyama

Watanabe

Kanai

et al. 2014

Orphanet J Rare Dis

Self Cite

View full text Add to dashboard Cite

Autoimmune pancreatitis (AIP) has been recognized as a distinct type of pancreatitis that is possibly caused by autoimmune mechanisms. AIP is characterized by high serum IgG4 and IgG4-positive plasma cell infiltration in affected pancreatic tissue. Acute phase AIP responds favorably to corticosteroid therapy and results in the amelioration of clinical findings. However, the long-term prognosis and outcome of AIP remain unclear. We have proposed a working hypothesis that AIP can develop into ordinary chronic pancreatitis resembling alcoholic pancreatitis over a long-term course based on several clinical findings, most notably frequent pancreatic stone formation. In this review article, we describe a series of study results to confirm our hypothesis and clarify that: 1) pancreatic calcification in AIP is closely associated with disease recurrence; 2) advanced stage AIP might have earlier been included in ordinary chronic pancreatitis; 3) approximately 40% of AIP patients experience pancreatic stone formation over a long-term course, for which a primary risk factor is narrowing of both Wirsung’s and Santorini’s ducts; and 4) nearly 20% of AIP patients progress to confirmed chronic pancreatitis according to the revised Japanese Clinical Diagnostic Criteria, with independent risk factors being pancreatic head swelling and non-narrowing of the pancreatic body duct.

show abstract

Section: Autoimmune Pancreatitis and Pancreatic Calcificationsupporting

confidence: 86%

Section: Autoimmune Pancreatitis and Pancreatic Calcificationmentioning

confidence: 99%