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自身免疫性胰腺炎与炎症性肠病:病例系列及文献综述

Autoimmune pancreatitis and inflammatory bowel disease: Case series and review of the literature.

作者信息

Roque Ramos Lídia, DiMaio Christopher J, Sachar David B, Atreja Ashish, Colombel Jean-Frédéric, Torres Joana

机构信息

Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal.

Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.

出版信息

Dig Liver Dis. 2016 Aug;48(8):893-8. doi: 10.1016/j.dld.2016.05.008. Epub 2016 May 19.

Abstract

BACKGROUND

An association between autoimmune pancreatitis (AIP) and inflammatory bowel disease (IBD) has been documented, but its clinical significance remains unclear.

AIMS

Characterize the particular phenotypes of IBD and AIP in patients with both diseases (IBD-AIP).

METHODS

Retrospective study of patients with IBD-AIP followed at our IBD referral centre and literature search to identify previous reports of IBD-AIP patients.

RESULTS

We found 5 cases of IBD-AIP in our records and 5 prior studies reporting 47 additional IBD-AIP patients. A combined analysis showed that most IBD-AIP patients were young males with ulcerative colitis, usually extensive, and that in all Crohn's disease cases, the colon was involved. IBD severity was heterogeneous across studies, ranging from mild disease to severe disease requiring colectomy. The most frequent type of AIP was idiopathic duct-centric pancreatitis (type 2) and it most often occurred after the diagnosis of IBD. AIP presentation and treatment were similar to those in the general population.

CONCLUSIONS

AIP occurs rarely with IBD; in the other way around, up to 1/3 of AIP patients, especially type 2, may have concomitant IBD. IBD-AIP patients are usually males presenting extensive colitis. More data are needed on the impact of AIP, if any, in IBD course.

摘要

背景

自身免疫性胰腺炎(AIP)与炎症性肠病(IBD)之间的关联已有文献记载,但其临床意义仍不明确。

目的

描述患有这两种疾病(IBD-AIP)的患者中IBD和AIP的特定表型。

方法

对在我们的IBD转诊中心随访的IBD-AIP患者进行回顾性研究,并进行文献检索以确定IBD-AIP患者的既往报告。

结果

我们在记录中发现了5例IBD-AIP患者,另有5项先前的研究报告了47例IBD-AIP患者。综合分析表明,大多数IBD-AIP患者是患有溃疡性结肠炎的年轻男性,通常病情广泛,并且在所有克罗恩病病例中,结肠均受累。不同研究中IBD的严重程度各不相同,从轻度疾病到需要结肠切除术的严重疾病。最常见的AIP类型是特发性导管中心性胰腺炎(2型),并且最常发生在IBD诊断之后。AIP的表现和治疗与普通人群相似。

结论

AIP与IBD同时发生的情况很少见;相反,高达1/3的AIP患者,尤其是2型患者,可能同时患有IBD。IBD-AIP患者通常为患有广泛性结肠炎的男性。关于AIP对IBD病程的影响(如果有),还需要更多数据。

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