Steroid therapy has an acceptable role as the initial treatment in autoimmune pancreatitis patients with pancreatic cyst formation: Based on a Japanese nationwide study

被引：0

作者：

Kubota, Kensuke ^{[1
]}

Oguchi, Takaya ^{[2
]}

Fujimori, Nao ^{[3
]}

Yamada, Kenta ^{[4
]}

Naitoh, Itaru ^{[5
]}

Okabe, Yoshinobu ^{[6
]}

Iwasaki, Eisuke ^{[7
]}

Masamune, Atsushi ^{[8
]}

Ikeura, Tsukasa ^{[9
]}

Kamisawa, Terumi ^{[10
]}

Inoue, Dai ^{[11
]}

Kumagi, Teru ^{[12
]}

Ogura, Takeshi ^{[13
]}

Kodama, Yuzo ^{[14
]}

Katanuma, Akio ^{[15
]}

Hirano, Kenji ^{[16
]}

Inui, Kazuo ^{[17
]}

Isayama, Hiroyuki ^{[18
]}

Sakagami, Junichi ^{[19
]}

Nishino, Takayoshi ^{[20
]}

Kanno, Atsushi ^{[21
]}

Kurita, Yusuke ^{[1
]}

Okazaki, Kazuichi ^{[9
]}

Nakamura, Seiji ^{[22
]}

机构：

[1] Yokohama City Univ Med, Endoscop Unit, 3-9 Fukuura, Yokohama, Kanagawa 2360004, Japan

[2] Shinshu Univ, Grad Sch Med, Dept Gastroenterol, Matsumoto, Nagano, Japan

[3] Kyushu Univ, Dept Gastroenterol, Grad Sch Med, Fukuoka, Japan

[4] Nagoya Univ, Grad Sch Med, Dept Gastroenterol, Nagoya, Aichi, Japan

[5] Nagoya City Univ, Dept Gastroenterol & Metab, Grad Sch Med Sci, Nagoya, Aichi, Japan

[6] Kurume Univ, Dept Gastroenterol, Kurume, Fukuoka, Japan

[7] Keio Univ, Dept Internal Med, Div Gastroenterol & Iepatol, Shinagawa Ku, Tokyo, Japan

[8] Tohoku Univ, Div Gastroenterol, Grad Sch Med, Sendai, Miyagi, Japan

[9] Kansai Med Univ, Dept Gastroenterol & Hepatol, Hirakata, Osaka, Japan

[10] Tokyo Komagome Metropolitan Hosp, Dept Internal Med, Tokyo, Japan

[11] Kanazawa Univ, Dept Radiol, Grad Sch Med, Kanazawa, Ishikawa, Japan

[12] Ehime Univ, Grad Sch Med, Dept Gastroenterol, Matsuyama, Ehime, Japan

[13] Osaka Med & Pharmaceut Univ, Dept Gastroenterol, Takatsuki, Osaka, Japan

[14] Kobe Univ, Dept Gastroenterol, Grad Sch Med, Kobe, Hyogo, Japan

[15] Teine Keijinkai Hosp, Dept Gastroenterol, Sapporo, Hokkaido, Japan

[16] Takanawa Hosp, Dept Gastroenterol, Tokyo, Japan

[17] Fujita Hlth Univ, Bantane Hosp, Dept Gastroenterol, Nagoya, Aichi, Japan

[18] Juntendo Univ, Dept Gastroenterol, Grad Sch Med, Tokyo, Japan

[19] Kyoto Prefectural Univ Med, Dept Gastroenterol, Kyoto, Japan

[20] Tokyo Womens Med Univ, Dept Gastroenterol, Yachiyo Med Ctr, Yachiyo, Japan

[21] Jichi Med Univ, Dept Gastroenterol, Shimono, Japan

[22] Kyushu Univ, Div Maxillofacial Diagnost & Surg Sci, Sect Oral & Maxillofacial Oncol, Fac Dent Sci, Fukuoka, Japan

来源：

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES | 2023年 / 30卷 / 05期

关键词：

autoimmune pancreatitis; cyst; relapse; remission; steroid; PAPILLARY MUCINOUS NEOPLASM; MANAGEMENT; PSEUDOCYSTS; CLASSIFICATION; GUIDELINES;

D O I：

10.1002/jhbp.1227

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background We attempted to determine the indications and limitations of steroid therapy as the first-line therapy in patients with autoimmune pancreatitis (AIP) with cyst formation (ACF). Methods This Japanese multicenter survey was conducted to examine the merits/demerits of steroid treatment as the initial therapy for ACF. Results Data of a total of 115 patients with ACF were analyzed. Complete remission was achieved in 86% (86/100) of patients who had received steroid treatment, but only 33.3% (5/15) of patients who had not received steroids. Relapse after the remission (n = 86) occurred in 7.6% (6/86) of patients who had received steroid therapy, but 40% (2/5) of patients who had not received steroid therapy. Multivariate analysis identified adoption of the wait and watch approach without steroid treatment (odds ratio = 0.126, P < .001) as a significant and independent negative predictor of remission of ACF. As for predictors of relapse, the presence of varix (odds ratio = 5.83, P = .036) was identified as an independent risk factor. Conclusion Steroid therapy plays an important role as first-line therapy in AIP patients with pancreatic cyst formation, however, varix formation, besides the diameter of the cyst(s), is a risk factor for refractoriness to steroid therapy.

引用

页码：664 / 677

页数：14