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 25 May 2018

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News

Features of autoimmune pancreatitis associated with IBD

A study in the latest issue of Clinical Gastroenterology & Hepatology described the association between IBD and AIP.

News image

Few people know of autoimmune pancreatitis (AIP), a rare disorder associated with inflammatory bowel diseases (IBD).

Dr Diane Lorenzo and colleagues from France described phenotype and outcomes of IBD and AIP when associated.

The research team performed a retrospective study of cases of AIP in IBD identified from the multicenter Groupe d’Etude Thérapeutique des Affections Inflammatoires du tube Digestif in Belgium and France from 2012 through 2015.

Patients were diagnosed with AIP based on the International Consensus Diagnostic Criteria for AIP.

A definitive AIP diagnosis was based on histological analysis of pancreatic resection specimens or samples collected by fine-needle aspiration during endoscopic ultrasound.

Over a mean follow-up period of 6 years, 34% relapsed
Clinical Gastroenterology & Hepatology

Patients with probable type 1 AIP were identified based on imaging findings, clinical and/or radiologic responses to steroids, level of serum immunoglobulin G4, and involvement of other organs.

Patients with probable type 2 AIP were identified based on imaging findings, clinical and/or radiologic responses to steroids, and association with IBD.

The team's primary objective was to collect information on the characteristics of AIP in patients with IBD.

The research team also compared features of patients with IBD with and without AIP in a case-control analysis, using multivariate analysis.

The research team analyzed data from 91 individuals with AIP and IBD seen at 23 centers.

The team found that 89 patients had type 2 AIP, and 2 patients had type 1 AIP.

The researcher's mean age at diagnosis of AIP was 35 years, and for IBD it was 32 years.

The team noted that AIP preceded IBD in 21% of patients.

Over a mean follow-up period of 6 years, 34% relapsed, 12% developed diabetes, and 19% developed exocrine pancreatic insufficiency.

In patients with UC, factors independently associated with AIP included proctitis and colectomy.

In patients with CD, the researchers found that AIP was significantly associated with fewer perianal lesions, non-stricturing non-penetrating CD, and higher rate of colectomy.

Dr Lorenzo's team concludes, "In a multicenter retrospective analysis of patients with AIP and IBD, followed for an average of 6 years, we found most to have type 2 AIP."

"Two-thirds of patients have UC, often with proctitis."

"One-third of patients have CD, often with inflammatory features."

"Patients with IBD and AIP have higher rates of colectomy than patients with just IBD."

Clin Gastroenterol Hepatol 2018: 16(1): 59–67
05 January 2018

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