Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation
Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation
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DOI：
10.1111/j.1572-0241.2004.04162.x
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发表时间：
2004-05-01
影响因子：
9.8
通讯作者：
Kawa, S
中科院分区：
文献类型：
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作者：
Takayama, M;Hamano, H;Kawa, S
目的：自身免疫性胰腺炎的特征在于主胰管的不规则狭窄和实质的超声肿胀，这两者都是由于疾病活动期的淋巴浆细胞性炎症，并且没有胰腺结石形成。本研究的目的是证实或否认这种疾病是否是进行性的反复发作，导致胰腺结石的形成，如普通的慢性胰腺炎。方法：42例患者，其中36例接受泼尼松龙治疗，随访时间超过12个月（中位随访期：54.5个月，范围：13-111个月）通过定期访谈和检查他们的医疗记录进行实验室检查和影像学检查。11例（26.2%）接受泼尼松龙治疗的患者在中位随访22个月期间复发。8例患者（19%）在随访期间显示胰腺结石形成。因为11名患者中有6名; 54.5%的复发患者有胰石形成，与无复发者相比，胰石形成与复发有显著相关性（P = 0.0019）。与以前的报道相反，我们观察到一些自身免疫性胰腺炎患者复发和胰腺结石形成，这表明自身免疫性胰腺炎有可能是伴随胰腺结石的进行性疾病。
OBJECTIVES: Autoimmune pancreatitis has been characterized by irregular narrowing of the main pancreatic duct and sonolucent swelling of the parenchyma, both of which are due to lymphoplasmacytic inflammation at the active stage of the disease, and by the absence of pancreatic stone formation. The aim of the present study was to confirm or deny whether or not this disease is progressive with recurrent attacks, resulting in pancreatic stone formation like ordinary chronic pancreatitis.METHODS: Forty-two patients, 36 of whom were treated with prednisolone, were followed up for periods longer than 12 months (median follow-up period: 54.5 months, range: 13-111 months) by regular interview and examination of their medical records for laboratory tests and image tests.RESULTS: Eleven patients (26.2%) who were treated with prednisolone Showed recurrent attacks during median follow-up periods of 22 months. Eight patients (19%) showed the formation of pancreatic stones during the follow-up periods. Because 6 of 11 patients; (54.5%) who suffered relapse showed pancreatic stone formation, it is significantly associated with relapse in comparison with nonrelapse (P = 0.0019).CONCLUSIONS: Contrary to previous reports, we observed both relapse and pancreatic stone formation in some patients with autoimmune pancreatitis, which suggests that autoimmune pancreatitis has the potential to be a progressive disease with pancreatic stones.