Risk Factors for Pancreatic Stone Formation in Type 1 Autoimmune Pancreatitis

A Long-term Japanese Multicenter Analysis of 624 Patients

Tetsuya Ito, Shigeyuki Kawa, Akihiro Matsumoto, Kensuke Kubota, Terumi Kamisawa, Kazuichi Okazaki, Kenji Hirano, Yoshiki Hirooka, Kazushige Uchida, Atsuhiro Masuda, Hirotaka Ohara, Kyoko Shimizu, Norikazu Arakura, Atsushi Masamune, Atsushi Kanno, Junichi Sakagami, Takao Itoi, Tetsuhide Ito, Toshiharu Ueki, Takayoshi Nishino & 8 others Kazuo Inui, Nobumasa Mizuno, Hitoshi Yoshida, Masanori Sugiyama, Eisuke Iwasaki, Atsushi Irisawa, Tooru Shimosegawa, Tsutomu Chiba

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective Autoimmune pancreatitis (AIP) has the potential to transform into chronic pancreatitis with pancreatic stone involvement. This retrospective investigation sought to clarify the risk factors for stone formation in type 1 AIP. Methods Questionnaires on patients with type 1 AIP were sent to 22 high-volume medical centers across Japan to compare the clinical features of patients with and without pancreatic stone formation. Results Of the completed records on 624 type 1 AIP patients, 31 (5%) had experienced pancreatic stones. Median follow-up duration was 1853 days. Bentiromide test values at diagnosis were significantly lower, and hemoglobin A 1c values after corticosteroid treatment were significantly higher in patients with pancreatic stones. Imaging results disclosed that pancreatic atrophy and hilar or intrahepatic bile duct stenosis were significantly more frequent in patients with pancreatic stone formation. Pancreatic head swelling tended to be more frequent in this group as well. On the other hand, a shorter follow-up period was associated with the nonformation of pancreatic stones. Conclusions The increased frequency of pancreatic head swelling in type 1 AIP patients exhibiting pancreatic stones indicated a propensity for pancreatic juice stasis with subsequent stone development and pancreatic dysfunction occurring over longer periods of disease duration.

Original languageEnglish
Pages (from-to)49-54
Number of pages6
JournalPancreas
Volume48
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Pancreatitis
Hemoglobin A
Intrahepatic Bile Ducts
Pancreatic Juice
Chronic Pancreatitis
Atrophy
Japan
Adrenal Cortex Hormones
Pathologic Constriction

Keywords

  • autoimmune pancreatitis
  • chronic pancreatitis
  • pancreatic stone
  • risk factor

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

Risk Factors for Pancreatic Stone Formation in Type 1 Autoimmune Pancreatitis : A Long-term Japanese Multicenter Analysis of 624 Patients. / Ito, Tetsuya; Kawa, Shigeyuki; Matsumoto, Akihiro; Kubota, Kensuke; Kamisawa, Terumi; Okazaki, Kazuichi; Hirano, Kenji; Hirooka, Yoshiki; Uchida, Kazushige; Masuda, Atsuhiro; Ohara, Hirotaka; Shimizu, Kyoko; Arakura, Norikazu; Masamune, Atsushi; Kanno, Atsushi; Sakagami, Junichi; Itoi, Takao; Ito, Tetsuhide; Ueki, Toshiharu; Nishino, Takayoshi; Inui, Kazuo; Mizuno, Nobumasa; Yoshida, Hitoshi; Sugiyama, Masanori; Iwasaki, Eisuke; Irisawa, Atsushi; Shimosegawa, Tooru; Chiba, Tsutomu.

In: Pancreas, Vol. 48, No. 1, 01.01.2019, p. 49-54.

Research output: Contribution to journalArticle

Ito, T, Kawa, S, Matsumoto, A, Kubota, K, Kamisawa, T, Okazaki, K, Hirano, K, Hirooka, Y, Uchida, K, Masuda, A, Ohara, H, Shimizu, K, Arakura, N, Masamune, A, Kanno, A, Sakagami, J, Itoi, T, Ito, T, Ueki, T, Nishino, T, Inui, K, Mizuno, N, Yoshida, H, Sugiyama, M, Iwasaki, E, Irisawa, A, Shimosegawa, T & Chiba, T 2019, 'Risk Factors for Pancreatic Stone Formation in Type 1 Autoimmune Pancreatitis: A Long-term Japanese Multicenter Analysis of 624 Patients', Pancreas, vol. 48, no. 1, pp. 49-54. https://doi.org/10.1097/MPA.0000000000001210
Ito, Tetsuya ; Kawa, Shigeyuki ; Matsumoto, Akihiro ; Kubota, Kensuke ; Kamisawa, Terumi ; Okazaki, Kazuichi ; Hirano, Kenji ; Hirooka, Yoshiki ; Uchida, Kazushige ; Masuda, Atsuhiro ; Ohara, Hirotaka ; Shimizu, Kyoko ; Arakura, Norikazu ; Masamune, Atsushi ; Kanno, Atsushi ; Sakagami, Junichi ; Itoi, Takao ; Ito, Tetsuhide ; Ueki, Toshiharu ; Nishino, Takayoshi ; Inui, Kazuo ; Mizuno, Nobumasa ; Yoshida, Hitoshi ; Sugiyama, Masanori ; Iwasaki, Eisuke ; Irisawa, Atsushi ; Shimosegawa, Tooru ; Chiba, Tsutomu. / Risk Factors for Pancreatic Stone Formation in Type 1 Autoimmune Pancreatitis : A Long-term Japanese Multicenter Analysis of 624 Patients. In: Pancreas. 2019 ; Vol. 48, No. 1. pp. 49-54.
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AU - Ito, Tetsuya

AU - Kawa, Shigeyuki

AU - Matsumoto, Akihiro

AU - Kubota, Kensuke

AU - Kamisawa, Terumi

AU - Okazaki, Kazuichi

AU - Hirano, Kenji

AU - Hirooka, Yoshiki

AU - Uchida, Kazushige

AU - Masuda, Atsuhiro

AU - Ohara, Hirotaka

AU - Shimizu, Kyoko

AU - Arakura, Norikazu

AU - Masamune, Atsushi

AU - Kanno, Atsushi

AU - Sakagami, Junichi

AU - Itoi, Takao

AU - Ito, Tetsuhide

AU - Ueki, Toshiharu

AU - Nishino, Takayoshi

AU - Inui, Kazuo

AU - Mizuno, Nobumasa

AU - Yoshida, Hitoshi

AU - Sugiyama, Masanori

AU - Iwasaki, Eisuke

AU - Irisawa, Atsushi

AU - Shimosegawa, Tooru

AU - Chiba, Tsutomu

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N2 - Objective Autoimmune pancreatitis (AIP) has the potential to transform into chronic pancreatitis with pancreatic stone involvement. This retrospective investigation sought to clarify the risk factors for stone formation in type 1 AIP. Methods Questionnaires on patients with type 1 AIP were sent to 22 high-volume medical centers across Japan to compare the clinical features of patients with and without pancreatic stone formation. Results Of the completed records on 624 type 1 AIP patients, 31 (5%) had experienced pancreatic stones. Median follow-up duration was 1853 days. Bentiromide test values at diagnosis were significantly lower, and hemoglobin A 1c values after corticosteroid treatment were significantly higher in patients with pancreatic stones. Imaging results disclosed that pancreatic atrophy and hilar or intrahepatic bile duct stenosis were significantly more frequent in patients with pancreatic stone formation. Pancreatic head swelling tended to be more frequent in this group as well. On the other hand, a shorter follow-up period was associated with the nonformation of pancreatic stones. Conclusions The increased frequency of pancreatic head swelling in type 1 AIP patients exhibiting pancreatic stones indicated a propensity for pancreatic juice stasis with subsequent stone development and pancreatic dysfunction occurring over longer periods of disease duration.

AB - Objective Autoimmune pancreatitis (AIP) has the potential to transform into chronic pancreatitis with pancreatic stone involvement. This retrospective investigation sought to clarify the risk factors for stone formation in type 1 AIP. Methods Questionnaires on patients with type 1 AIP were sent to 22 high-volume medical centers across Japan to compare the clinical features of patients with and without pancreatic stone formation. Results Of the completed records on 624 type 1 AIP patients, 31 (5%) had experienced pancreatic stones. Median follow-up duration was 1853 days. Bentiromide test values at diagnosis were significantly lower, and hemoglobin A 1c values after corticosteroid treatment were significantly higher in patients with pancreatic stones. Imaging results disclosed that pancreatic atrophy and hilar or intrahepatic bile duct stenosis were significantly more frequent in patients with pancreatic stone formation. Pancreatic head swelling tended to be more frequent in this group as well. On the other hand, a shorter follow-up period was associated with the nonformation of pancreatic stones. Conclusions The increased frequency of pancreatic head swelling in type 1 AIP patients exhibiting pancreatic stones indicated a propensity for pancreatic juice stasis with subsequent stone development and pancreatic dysfunction occurring over longer periods of disease duration.

KW - autoimmune pancreatitis

KW - chronic pancreatitis

KW - pancreatic stone

KW - risk factor

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