Autoimmune Pancreatitis in Patients with Inflammatory Bowel Disease: A Real-World Multicentre Collaborative ECCO CONFER Study.

IF 8.3 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Journal of Crohns & Colitis Pub Date : 2023-11-24 DOI:10.1093/ecco-jcc/jjad097
Piotr Eder, Bram Verstock, Emma Culver, Gabriele Dragoni, Lea Isabell Kredel, Joanna Wypych, Ana Garcia Garcia de Paredes, Magdalena Kaniewska, Haim Leibovitzh, Triana Lobaton, Marie Truyens, Grzegorz Oracz, Davide Giuseppe Ribaldone, Teresa Starzyńska, Abdenor Badaoui, Jean-Francois Rahier, Cristina Bezzio, Peter Bossuyt, Katherine Falloon, Daniela Pugliese, Catherine Frakes Vozzo, Tine Jess, Lone Larsen, Søren Schou Olesen, Partha Pal, María Chaparro, Dikla Dror, Pierre Ellul, Iga Gromny, Maria Janiak, Katarzyna Maciejewska, Noam Peleg, Ariella Bar-Gil Shitrit, Łukasz Szwed, Renata Talar-Wojnarowska, Yifat Snir, Roni Weisshof, Eran Zittan, Izabela Miechowicz, Idan Goren
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Abstract

Background: Autoimmune pancreatitis [AIP] is rarely associated with inflammatory bowel disease [IBD]. The long-term outcomes of AIP and IBD in patients with coexisting AIP-IBD and predictors of complicated AIP course have rarely been reported.

Methods: An ECCO COllaborative Network For Exceptionally Rare case reports project [ECCO-CONFER] collected cases of AIP diagnosed in patients with IBD. Complicated AIP was defined as a composite of endocrine and/or exocrine pancreatic insufficiency, and/or pancreatic cancer. We explored factors associated with complicated AIP in IBD.

Results: We included 96 patients [53% males, 79% ulcerative colitis, 72% type 2 AIP, age at AIP diagnosis 35 ± 16 years]. The majority of Crohn's disease [CD] cases [78%] had colonic/ileocolonic involvement. In 59%, IBD preceded AIP diagnosis, whereas 18% were diagnosed simultaneously. Advanced therapy to control IBD was used in 61% and 17% underwent IBD-related surgery. In total, 82% of patients were treated with steroids for AIP, the majority of whom [91%] responded to a single course of treatment. During a mean follow-up of 7 years, AIP complications occurred in 25/96 [26%] individuals. In a multivariate model, older age at AIP diagnosis was associated with a complicated AIP course (odds ratio [OR] = 1.05, p = 0.008), whereas family history of IBD [OR = 0.1, p = 0.03], and CD diagnosis [OR = 0.2, p = 0.04] decreased the risk of AIP complications. No IBD- or AIP-related deaths occurred.

Conclusions: In this large international cohort of patients with concomitant AIP-IBD, most patients have type 2 AIP and colonic IBD. AIP course is relatively benign and long-term outcomes are favourable, but one-quarter develop pancreatic complications. Age, familial history of IBD, and CD may predict uncomplicated AIP course.

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炎症性肠病患者的自身免疫性胰腺炎:一项真实世界多中心ECCO协作研究
背景:自身免疫性胰腺炎[AIP]很少与炎症性肠病[IBD]相关。合并AIP-IBD患者的AIP和IBD的长期预后以及复杂AIP病程的预测因素很少有报道。方法:ECCO异常罕见病例报告合作网络项目[ECCO- confer]收集了IBD患者诊断为AIP的病例。复杂性AIP被定义为内分泌和/或外分泌胰腺功能不全和/或胰腺癌的复合。我们探讨了IBD并发AIP的相关因素。结果:纳入96例患者[男性53%,溃疡性结肠炎79%,2型AIP 72%,诊断年龄35±16岁]。大多数克罗恩病(CD)病例(78%)累及结肠/回结肠。59%的患者IBD先于AIP诊断,18%的患者同时诊断。61%的患者采用了先进的治疗方法来控制IBD, 17%的患者接受了IBD相关手术。总的来说,82%的AIP患者接受了类固醇治疗,其中大多数[91%]对单一疗程的治疗有反应。平均随访7年,25/96例(26%)患者出现AIP并发症。在一个多变量模型中,诊断为AIP时年龄较大与复杂的AIP病程相关(比值比[OR] = 1.05, p = 0.008),而IBD家族史[OR = 0.1, p = 0.03]和CD诊断[OR = 0.2, p = 0.04]降低了AIP并发症的风险。无IBD或aip相关死亡发生。结论:在这个合并AIP-IBD患者的大型国际队列中,大多数患者患有2型AIP和结肠IBD。AIP病程相对良性,长期预后良好,但1 / 4发生胰腺并发症。年龄、IBD家族史和CD可以预测不复杂的AIP病程。
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来源期刊
Journal of Crohns & Colitis
Journal of Crohns & Colitis 医学-胃肠肝病学
CiteScore
15.50
自引率
7.50%
发文量
1048
审稿时长
1 months
期刊介绍: Journal of Crohns and Colitis is concerned with the dissemination of knowledge on clinical, basic science and innovative methods related to inflammatory bowel diseases. The journal publishes original articles, review papers, editorials, leading articles, viewpoints, case reports, innovative methods and letters to the editor.
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