The Characteristics of Ulcerative Colitis Associated With Autoimmune Pancreatitis

Park, Sang Hyoung; Kim, Donghoi; Ye, Byong Duk; Yang, Suk‐Kyun; Kim, Ji Hun; Yang, Dan; Jung, Kee Wook; Kim, Kyung‐Jo; Byeon, Jeong‐Sik; Myung, Seung‐Jae; Kim, Myung–Hwan; Kim, Jin-Ho

doi:10.1097/mcg.0b013e31827fd4a2

Cited by 51 publications

(72 citation statements)

References 46 publications

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“…Finally, regarding AIP, it was found that its frequency in patients with IBD is 0.04%; this value was lower than the 0.4% previously reported [4,5] but was similar to that reported in a study carried out in the United States [6] . The reason for this could have been due to the underdiagnosis of AIP because it is not routinely investigated.…”

Section: Discussioncontrasting

confidence: 49%

“…Regarding autoimmune pancreatitis (AIP), the overall reported prevalence of this disease in IBD patients is approximately 0.5% in the Asian population [4,5], whereas in western countries and specifically in the United States, it is much lower [6] . Thus, the purpose of this study was to assess the frequency of benign pancreatic diseases, that is, acute pancreatitis, chronic pancreatitis (CP), and AIP, in a population with IBD treated in our hospital.…”

Section: Introductionmentioning

confidence: 99%

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Benign Exocrine Pancreatic Diseases in Inflammatory Bowel Diseases

Pezzilli

Pagano²

2017

Dig Dis

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Background: Data regarding the involvement of the pancreas during the course of inflammatory bowel disease (IBD) are scarce and conflicting. Aim: To assess the frequency of benign pancreatic diseases, that is, acute pancreatitis, chronic pancreatitis (CP), and autoimmune pancreatitis (AIP), in a population with IBD. Methods: A search for patients with IBD who presented at our hospital between January 2006 and January 2015 with a diagnosis of IBD was carried out. Patients: A total of 5,242 patients with IBD were included in this study (2,838 males, 54.1%, and 2,404 females, 45.9%, mean age 43.7 years, range 18-101 years). Of these 5,242 patients, 3,201 (61.1%) had Crohn's disease and 2,041 (38.9%) had ulcerative colitis (UC). Results: Thirteen patients developed benign pancreatic diseases (0.2%). Eight patients had acute pancreatitis (0.2%; 4 in the Crohn's disease group and 4 in the UC group), 3 had CP (0.1%, 2 in the Crohn's disease group and 1 in the UC group), 2 had AIP (0.04%), all in the group of diffuse UC (p = 0.321). Conclusions: The frequency of benign pancreatic disease was not high in patients with IBD and was probably similar to that seen in the general population.

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Section: Discussioncontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Benign Exocrine Pancreatic Diseases in Inflammatory Bowel Diseases

Pezzilli

Pagano²

2017

Dig Dis

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“…Gallstones and alcohol abuse are also long-established risk factors for acute pancreatitis[12]. The relationship between IBD and autoimmune pancreatitis (AIP) is mainly confined to UC[13,14]. Several studies have reported positive associations between risk for acute pancreatitis and IBD severity[15-17].…”

Section: Introductionmentioning

confidence: 99%

Clinical course of ulcerative colitis patients who develop acute pancreatitis

Kim

Hwang

Park

et al. 2017

WJG

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AIMTo investigate the clinical course of ulcerative colitis (UC) patients who develop acute pancreatitis.METHODSWe analyzed 3307 UC patients from the inflammatory bowel disease registry at Asan Medical Center from June 1989 to May 2015. The clinical course of UC patients who developed acute pancreatitis was compared with that of non-pancreatitis UC patients.RESULTSAmong 51 patients who developed acute pancreatitis, 13 (0.40%) had autoimmune, 10 (0.30%) had aminosalicylate-induced, and 13 (1.73%) had thiopurine-induced pancreatitis. All 13 patients with autoimmune pancreatitis (AIP) had type 2 AIP. Two (15.4%) patients had pre-existing AIP, and three (23.1%) patients developed AIP and UC simultaneously. Compared to non-pancreatitis patients, AIP patients had UC diagnosed at a significantly younger age (median, 22.9 years vs 36.4 years; P = 0.001). AIP and aminosalicylate-induced pancreatitis patients had more extensive UC compared to non-pancreatitis patients. All patients with pancreatitis recovered uneventfully, and there were no recurrences. Biologics were used more frequently in aminosalicylate- and thiopurine-induced pancreatitis patients compared to non-pancreatitis patients [adjusted OR (95%CI), 5.16 (1.42-18.67) and 6.90 (1.83-25.98), respectively]. Biologic utilization rate was similar among AIP and non-pancreatitis patients [OR (95%CI), 0.84 (0.11-6.66)]. Colectomy rates for autoimmune, aminosalicylate-induced, and thiopurine-induced pancreatitis, and for non-pancreatitis patients were 15.4% (2/13), 20% (2/10), 15.4% (2/13), and 7.3% (239/3256), respectively; the rates were not significantly different after adjusting for baseline disease extent.CONCLUSIONPancreatitis patients show a non-significant increase in colectomy, after adjusting for baseline disease extent.

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“…Although Ravi et al11 reported infiltration of IgG4-positive cells in the colonic mucosa of one patient with AIP and UC, and concluded that IBD might represent an extrapancreatic manifestation of AIP, whether this AIP was type 1 or type 2 was unclear. Park et al24 reported that six cases (5.8%) of the 104 AIP patients were diagnosed with UC, and two cases (33.3%) showed increased infiltration of IgG4-positive plasma cells into the colonic mucosa, but none with UC only. They hypothesized that UC may be an extrapancreatic manifestation of AIP.…”

Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis and Immunoglobulin G4

et al. 2014

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Background/AimsUlcerative colitis (UC) is sometimes associated with autoimmune pancreatitis (AIP). Infiltration of immunoglobulin G4 (IgG4)-positive plasma cells is sometimes detected in the colonic mucosa of AIP or UC patients. This study aimed to clarify the relation between UC and IgG4.MethodsAssociations with UC were reviewed in 85 AIP patients. IgG4 immunostaining was performed on biopsy specimens from the colonic mucosa of 14 AIP and 32 UC patients.ResultsUC was confirmed in two cases (type 1 AIP, n=1; suspected type 2 AIP, n=1). Abundant infiltration of IgG4-positive plasma cells in the colonic mucosa was detected in the case of suspected type 2 AIP with UC and two cases of type 1 AIP without colitis. Abundant infiltration of IgG4-positive plasma cells was detected in 10 UC cases (IgG4-present, 31%). Although 72% of IgG4-absent UC patients showed mild disease activity, 70% of IgG4-present patients showed moderate to severe disease activity (p<0.05).ConclusionsUC is sometimes associated with AIP, but it seems that UC is not a manifestation of IgG4-related disease. Infiltration of IgG4-positive plasma cells is sometimes detectable in the colonic mucosa of UC patients and is associated with disease activity.

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The Characteristics of Ulcerative Colitis Associated With Autoimmune Pancreatitis

Abstract: AIP patients seem to have a higher risk of UC compared with the general population. The increased IgG4-positive cellular infiltration in the colonic tissue suggests that UC may be an extrapancreatic manifestation of AIP.

Cited by 51 publications

References 46 publications

Benign Exocrine Pancreatic Diseases in Inflammatory Bowel Diseases

Benign Exocrine Pancreatic Diseases in Inflammatory Bowel Diseases

Clinical course of ulcerative colitis patients who develop acute pancreatitis

Ulcerative Colitis and Immunoglobulin G4

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