1. Autoimmune pancreatitis in patients with inflammatory bowel disease - a real-world multicentre collaborative ECCO CONFER study
- Author
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Eder, Piotr, Verstock, Bram, Culver, Emma, Dragoni, Gabriele, Kredel, Lea Isabell, Wypych, Joanna, de Paredes, Ana Garcia Garcia, Kaniewska, Magdalena, Leibovitzh, Haim, Lobaton, Triana, Truyens, Marie, Oracz, Grzegorz, Ribaldone, Davide Giuseppe, Starzyńska, Teresa, Badaoui, Abdenor, Rahier, Jean-François, Bezzio, Cristina, Bossuyt, Peter, Falloon, Katherine, Pugliese, Daniela, Vozzo, Catherine Frakes, Jess, Tine, Larsen, Lone, Olensen, Soren, Pal, Partha, Chaparro, María, Dror, Dikla, Ellul, Pierre, Gromny, Iga, Janiak, Maria, Maciejewska, Katarzyna, Peleg, Noam, Shitrit, Ariella Bar-Gil, Szwed, Łukasz, Talar-Wojnarowska, Renata, Snir, Yifat, Weisshof, Roni, Zittan, Eran, Miechowicz, Izabela, Goren, Idan, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service de gastro-entérologie
- Subjects
inflammatory bowel disease ,pancreatic insufficiency ,autoimmune pancreatitis - Abstract
BackgroundAutoimmune pancreatitis (AIP) is rarely associated with inflammatory bowel disease (IBD). Long-term outcomes of AIP and IBD in patients with AIP-IBD coexistence and predictors of complicated AIP course are scarcely known.MethodsAn 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.ResultsWe 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. 82% of patients were treated with steroids for AIP, the majority of which (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, younger age at AIP diagnosis (OR=1.05, P=0.008), family history of IBD (OR=0.1, P=0.03) and CD diagnosis (OR=0.2, P=0.04) were associated with uncomplicated AIP course. No IBD or AIP-related deaths occurred.ConclusionsIn 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, however, one-quarter develop pancreatic complications. Age, familial history of IBD and CD may predict uncomplicated AIP course.
- Published
- 2023