Division of Gastroenterology,Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
Pancreas. 2010 Jan;39(1):e6-10. doi: 10.1097/MPA.0b013e3181bc119d.
Patients with autoimmune pancreatitis (AIP) sometimes present with Mikulicz disease (MD); however, the clinical features regarding these AIP patients with MD have not yet been fully elucidated. Our aim is to study the clinical differences between AIP with and without MD.
Twenty-eight AIP patients were divided into 2 groups, one with MD and one without it. The following factors having a possible association with the presence or absence of MD were investigated: sex; serum IgG and IgG4 levels; the presence or absence of antinuclear autoantibodies, jaundice, diabetes mellitus, swollen duodenal papilla, diffuse pancreatic swelling, spontaneous remission, and relapse.
The MD and non-MD groups consisted of 5 AIP and 23 AIP patients, respectively. The results of univariate analysis revealed that AIP patients presenting with MD were significantly associated with a younger onset, female predominance, high serum IgG4 titer, and diffuse pancreatic swelling (P < 0.05). In 4 of the MD patients, onset preceded pancreatitis.
Autoimmune pancreatitis patients presenting with MD tended to have different clinical features from the non-MD AIP patients, such as having an earlier onset, female tendency, and diffuse pancreatic swelling with a high titer of serum IgG4. Autoimmune pancreatitis with MD tended to precede gastroenterological events.
自身免疫性胰腺炎（AIP）患者有时会出现米库利兹病（MD）；然而，这些伴有 MD 的 AIP 患者的临床特征尚未完全阐明。我们的目的是研究伴有和不伴有 MD 的 AIP 患者的临床差异。
将 28 例 AIP 患者分为 2 组，一组伴有 MD，一组不伴有 MD。研究了可能与 MD 存在或不存在相关的以下因素：性别；血清 IgG 和 IgG4 水平；是否存在抗核自身抗体、黄疸、糖尿病、十二指肠乳头肿胀、弥漫性胰腺肿胀、自发性缓解和复发。
MD 组和非 MD 组分别有 5 例和 23 例 AIP 患者。单因素分析结果显示，伴有 MD 的 AIP 患者发病年龄较早、女性居多、血清 IgG4 滴度较高、弥漫性胰腺肿胀（P<0.05）。在 4 例 MD 患者中，胰腺炎发病前有 MD 发作。
伴有 MD 的 AIP 患者的临床特征与非 MD 的 AIP 患者不同，例如发病年龄较早、女性倾向和弥漫性胰腺肿胀伴血清 IgG4 滴度较高。伴有 MD 的 AIP 倾向于先出现胃肠道事件。
