Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Pancreas. 2010 Jan;39(1):e1-5. doi: 10.1097/MPA.0b013e3181bd64a1.
To clarify the frequency and clinical significance of extrapancreatic lesions in autoimmune pancreatitis (AIP).
The frequency and clinical characteristics of extrapancreatic lesions during the clinical course of AIP were investigated retrospectively in 64 patients with AIP. The predictive factors for relapse of AIP at clinical onset were also examined.
Extrapancreatic lesions occurred in 95% (61/64) during the clinical course of AIP. The frequencies of sclerosing cholangitis, sclerosing sialadenitis, retroperitoneal fibrosis, and mediastinal or hilar lymphadenopathy were 84% (54/64), 23% (15/64), 16% (10/64), and 77% (27/35), respectively. Patients with sclerosing sialadenitis or extrapancreatic bile duct sclerosing cholangitis had a significantly higher serum immunoglobulin G concentration than those without (P = 0.005 and P = 0.016, respectively). Univariate analysis revealed that sclerosing sialadenitis (P = 0.005), diffuse pancreatic ductal changes (P = 0.028), and a high serum immunoglobulin G concentration (P = 0.030) at clinical onset of AIP were significant predictive factors for relapse. Multivariate analysis revealed that diffuse pancreatic ductal changes (P = 0.005) and sclerosing sialadenitis (P = 0.012) were significant independent predictive factors for relapse of AIP.
The frequency of extrapancreatic lesions with AIP during the clinical course was high. The presence of sclerosing sialadenitis at clinical onset is a significant predictive factor for relapse of AIP.
阐明自身免疫性胰腺炎（AIP）中胰外病变的频率和临床意义。
回顾性研究 64 例 AIP 患者的临床病程中外周病变的频率和临床特征。还检查了 AIP 发病时复发的预测因素。
AIP 临床病程中外周病变发生率为 95%（61/64）。硬化性胆管炎、硬化性唾液腺炎、腹膜后纤维化和纵隔或肺门淋巴结肿大的发生率分别为 84%（54/64）、23%（15/64）、16%（10/64）和 77%（27/35）。有硬化性唾液腺炎或胰外胆管硬化性胆管炎的患者血清 IgG 浓度明显高于无硬化性唾液腺炎或胰外胆管硬化性胆管炎的患者（P = 0.005 和 P = 0.016）。单因素分析显示，AIP 发病时的硬化性唾液腺炎（P = 0.005）、弥漫性胰管改变（P = 0.028）和高血清 IgG 浓度（P = 0.030）是复发的显著预测因素。多因素分析显示，弥漫性胰管改变（P = 0.005）和硬化性唾液腺炎（P = 0.012）是 AIP 复发的显著独立预测因素。
AIP 临床病程中外周病变的频率较高。发病时存在硬化性唾液腺炎是 AIP 复发的显著预测因素。
Zotero 插件