Exocrine and Endocrine Pancreatic Function in 21 Patients Suffering from Autoimmune Pancreatitis before and after Steroid Treatment |
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| Authors: | Luca Frulloni Chiara Scattolini Anna Maria Katsotourchi Antonio Amodio Armando Gabbrielli Giuseppe Zamboni Luigi Benini Italo Vantini |
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| Affiliation: | 1. Departments of Biomedical and Surgical Sciences, Verona, Italy;2. Pathology, University of Verona, Verona, Italy;1. Department of Pediatrics, Shanghai East Hospital, Shanghai East Hospital of Tongji University, 200120 Shanghai, China;2. Department of Pediatrics, Changzheng Hospital Affiliated to the SMMU, 200003 Shanghai, China;3. Department of Clinical Pharmacy, College of Pharmacy, China Pharmaceutical University, 211198 Nanjing, China;4. Department of Pediatrics, Zhabei District Central Hospital, 200070 Shanghai, China;1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea;2. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea;3. Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea;4. Department of Internal Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea;1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA;2. Department of Pediatrics, Mayo Clinic, Rochester, Minnesota, USA;3. Division of Radiology, Mayo Clinic, Rochester, Minnesota, USA;4. Division of Pathology, Mayo Clinic, Rochester, Minnesota, USA;1. Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;2. Department of Pathology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;3. Department of Nuclear Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;4. Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;5. Department of General Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;6. Department of Surgical Oncology, Chinese PLA General Hospital, Beijing 100853, China;7. Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China;1. Internal medicine department hospital universitari Vall d’Hebron, 08035 Barcelona, Spain;2. Rheumatology division, department of medicine, university of Western Ontario, London, N6A 4V2 ON, Canada;3. Internal medicine department, hospital general universitario Gregorio Marañón, 28007 Madrid, Spain;4. Muscle disease unit, national institute of arthritis and musculoskeletal and skin diseases, Bethesda, 20892 Maryland, United States;5. Internal medicine department, hospital Ramón y Cajal, 28007 Madrid, Spain;6. Internal medicine department, hospital de Cabueñes, 33394 Gijón, Spain;7. Internal medicine department, hospital clínico universitario de Santiago, 15706 Santiago de Compostela, Spain;8. Internal medicine department, hospital Clínic i Provincial, 08036 Barcelona, Spain;9. Internal medicine department, consorci sanitari Parc Taulí, 08208 Sabadell, Spain;10. Internal medicine department, hospital Joan XXXIII, 43005 Tarragona, Spain;1. Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan;2. Department of Gastroenterology, Sendai Medical Center, Sendai, Miyagi, Japan;3. Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan;4. Molecular Epidemiology, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan |
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| Abstract: | Background/Aim: Autoimmune pancreatitis (AIP) responds rapidly and dramatically to steroid therapy. The aim of this study was to evaluate pancreatic exocrine and endocrine function in patients suffering from AIP both before and after steroid therapy. Patients and Methods: Fecal elastase 1 and diabetes were evaluated before steroid therapy and within 1 month of its suspension in 21 patients (13 males and 8 females, mean age 43 ± 16.5 years) diagnosed as having AIP between 2006 and 2008. Results: At clinical onset, fecal elastase 1 was 107 ± 126μg/g stool.Thirteen patients (62%) showed severe pancreatic insufficiency (<100 μg/g stool), 4 (19%) had mild insufficiency (100–200 μg/g stool), while 4 (19%) had normal pancreatic function (1200 μg/g stool). Before steroids, diabetes was diagnosed in 5 patients (24%), all of whom had very low levels of fecal elastase 1 (<19 μg/g stool). Following steroids, fecal elastase 1 increased in all patients (237 8 193 μg/g stool) and observed levels were significantly higher than those seen before steroids (p = 0.001). Conclusions: Patients suffering from AIP display exocrine and/or endocrine pancreatic insufficiency at clinical onset. These insufficiencies improve after steroid therapy. |
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