Cargando…
Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus
BACKGROUND AND AIM: Relapse and diabetes mellitus (DM) are major problems for the prognosis of autoimmune pancreatitis (AIP). We examined the prognosis of type 1 AIP after corticosteroid therapy (CST)-induced remission in terms of relapse and DM. METHODS: The study enrolled 82 patients diagnosed wit...
Autores principales: | , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5699801/ https://www.ncbi.nlm.nih.gov/pubmed/29166415 http://dx.doi.org/10.1371/journal.pone.0188549 |
_version_ | 1783281017207914496 |
---|---|
author | Miyazawa, Masaki Takatori, Hajime Shimakami, Tetsuro Kawaguchi, Kazunori Kitamura, Kazuya Arai, Kuniaki Matsuda, Koichiro Sanada, Taku Urabe, Takeshi Inamura, Katsuhisa Kagaya, Takashi Mizuno, Hideki Fuchizaki, Uichiro Yamashita, Taro Sakai, Yoshio Yamashita, Tatsuya Mizukoshi, Eishiro Honda, Masao Kaneko, Shuichi |
author_facet | Miyazawa, Masaki Takatori, Hajime Shimakami, Tetsuro Kawaguchi, Kazunori Kitamura, Kazuya Arai, Kuniaki Matsuda, Koichiro Sanada, Taku Urabe, Takeshi Inamura, Katsuhisa Kagaya, Takashi Mizuno, Hideki Fuchizaki, Uichiro Yamashita, Taro Sakai, Yoshio Yamashita, Tatsuya Mizukoshi, Eishiro Honda, Masao Kaneko, Shuichi |
author_sort | Miyazawa, Masaki |
collection | PubMed |
description | BACKGROUND AND AIM: Relapse and diabetes mellitus (DM) are major problems for the prognosis of autoimmune pancreatitis (AIP). We examined the prognosis of type 1 AIP after corticosteroid therapy (CST)-induced remission in terms of relapse and DM. METHODS: The study enrolled 82 patients diagnosed with type 1 AIP who achieved remission with CST. We retrospectively evaluated the relapse rate in terms of the administration period of CST, clinical factors associated with relapse, and the temporal change in glucose tolerance. RESULTS: During follow-up, 32 patients (39.0%) experienced relapse. There was no significant clinical factor that could predict relapse before beginning CST. AIP patients who ceased CST within 2 or 3 years experienced significantly earlier relapse than those who had the continuance of CST (p = 0.050 or p = 0.020). Of the 37 DM patients, 15 patients (40.5%) had pre-existing DM, 17 (45.9%) showed new-onset DM, and 5 (13.5%) developed CST-induced DM. Patients with new-onset DM were significantly more likely to show improvement (p = 0.008) than those with pre-existing DM. CONCLUSIONS: It was difficult to predict relapse of AIP based on clinical parameters before beginning CST. Relapse was likely to occur within 3 years after the beginning of CST and maintenance of CST for at least 3 years reduced the risk of relapse. The early initiation of CST for AIP with impaired glucose tolerance is desirable because pre-existing DM is refractory to CST. |
format | Online Article Text |
id | pubmed-5699801 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-56998012017-12-08 Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus Miyazawa, Masaki Takatori, Hajime Shimakami, Tetsuro Kawaguchi, Kazunori Kitamura, Kazuya Arai, Kuniaki Matsuda, Koichiro Sanada, Taku Urabe, Takeshi Inamura, Katsuhisa Kagaya, Takashi Mizuno, Hideki Fuchizaki, Uichiro Yamashita, Taro Sakai, Yoshio Yamashita, Tatsuya Mizukoshi, Eishiro Honda, Masao Kaneko, Shuichi PLoS One Research Article BACKGROUND AND AIM: Relapse and diabetes mellitus (DM) are major problems for the prognosis of autoimmune pancreatitis (AIP). We examined the prognosis of type 1 AIP after corticosteroid therapy (CST)-induced remission in terms of relapse and DM. METHODS: The study enrolled 82 patients diagnosed with type 1 AIP who achieved remission with CST. We retrospectively evaluated the relapse rate in terms of the administration period of CST, clinical factors associated with relapse, and the temporal change in glucose tolerance. RESULTS: During follow-up, 32 patients (39.0%) experienced relapse. There was no significant clinical factor that could predict relapse before beginning CST. AIP patients who ceased CST within 2 or 3 years experienced significantly earlier relapse than those who had the continuance of CST (p = 0.050 or p = 0.020). Of the 37 DM patients, 15 patients (40.5%) had pre-existing DM, 17 (45.9%) showed new-onset DM, and 5 (13.5%) developed CST-induced DM. Patients with new-onset DM were significantly more likely to show improvement (p = 0.008) than those with pre-existing DM. CONCLUSIONS: It was difficult to predict relapse of AIP based on clinical parameters before beginning CST. Relapse was likely to occur within 3 years after the beginning of CST and maintenance of CST for at least 3 years reduced the risk of relapse. The early initiation of CST for AIP with impaired glucose tolerance is desirable because pre-existing DM is refractory to CST. Public Library of Science 2017-11-22 /pmc/articles/PMC5699801/ /pubmed/29166415 http://dx.doi.org/10.1371/journal.pone.0188549 Text en © 2017 Miyazawa et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Miyazawa, Masaki Takatori, Hajime Shimakami, Tetsuro Kawaguchi, Kazunori Kitamura, Kazuya Arai, Kuniaki Matsuda, Koichiro Sanada, Taku Urabe, Takeshi Inamura, Katsuhisa Kagaya, Takashi Mizuno, Hideki Fuchizaki, Uichiro Yamashita, Taro Sakai, Yoshio Yamashita, Tatsuya Mizukoshi, Eishiro Honda, Masao Kaneko, Shuichi Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus |
title | Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus |
title_full | Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus |
title_fullStr | Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus |
title_full_unstemmed | Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus |
title_short | Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus |
title_sort | prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5699801/ https://www.ncbi.nlm.nih.gov/pubmed/29166415 http://dx.doi.org/10.1371/journal.pone.0188549 |
work_keys_str_mv | AT miyazawamasaki prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT takatorihajime prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT shimakamitetsuro prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT kawaguchikazunori prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT kitamurakazuya prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT araikuniaki prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT matsudakoichiro prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT sanadataku prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT urabetakeshi prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT inamurakatsuhisa prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT kagayatakashi prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT mizunohideki prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT fuchizakiuichiro prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT yamashitataro prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT sakaiyoshio prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT yamashitatatsuya prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT mizukoshieishiro prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT hondamasao prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus AT kanekoshuichi prognosisoftype1autoimmunepancreatitisaftercorticosteroidtherapyinducedremissionintermsofrelapseanddiabetesmellitus |