Classic chronic pancreatitis is associated with prior acute pancreatitis in only 50% of patients in a large single-institution study
Autor: | Ferga C. Gleeson, Yasuki Hori, Michael L. Kendrick, Michael J. Levy, Rory L. Smoot, Mark Topazian, Bret T. Petersen, Naoki Takahashi, Randall K. Pearson, Santhi Swaroop Vege, Mark J. Truty, Suresh T. Chari |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Population Gastroenterology Cohort Studies Pathogenesis 03 medical and health sciences 0302 clinical medicine Risk Factors Pancreatitis Chronic Internal medicine medicine Humans In patient Single institution education Aged Retrospective Studies education.field_of_study Hepatology business.industry Incidence (epidemiology) Middle Aged medicine.disease 030220 oncology & carcinogenesis Cohort Pancreatitis Acute pancreatitis Female 030211 gastroenterology & hepatology business |
Zdroj: | Pancreatology. 19:224-229 |
ISSN: | 1424-3903 |
Popis: | The sentinel acute pancreatitis event (SAPE) hypothesis for pathogenesis of chronic pancreatitis (CP) postulates that acute pancreatitis (AP), especially recurrent AP (RAP), precedes development of CP. However, in a recent population-based study, 52/89 (58.4%) of CP had no prior episodes of AP. In a large clinic-based CP cohort, we aimed to determine the incidence and timing of prior AP in patients diagnosed with CP.We retrospectively identified 499 consecutive patients with classic CP diagnosed at our institution from January 2013 through December 2015. We abstracted their demographic and clinical data, especially regarding prior AP.We identified 3 cohorts: 1) CP with no AP (n = 231 [46.3%]), 2) AP before CP (n = 250 [50.1%]), and 3) AP after CP (n = 18 [3.6%]). At CP diagnosis, 249 patients (49.9%) had no prior AP. Compared with the "CP preceded by AP" cohort, the "CP without AP"' cohort was older (59.2 ± 13.9 vs 48.6 ± 15.7 years; P .001), had a higher prevalence of diabetes mellitus (30.3% vs 12.4%; P .001), reported less pain (52.8% vs 87.6%; P .001), and had a lower rate of endoscopic interventions (16.0% vs 39.2%; P .001). In the "CP preceded by AP" cohort, 117 (46.8%) had a single episode of AP and 133 (53.2%) had RAP.Nearly half the patients with classic CP did not have prior AP. Only a quarter of patients had CP that could potentially have evolved from prior RAP. Development of CP may be attributable to an altogether different pathogenesis (a non-SAPE pathway) for a considerable proportion of patients. |
Databáze: | OpenAIRE |
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