Idiopathic acute pancreatitis in patients with inflammatory bowel disease: A multicenter cohort study
| Autor: | Reyes Busta, Marisa Iborra, Agustín Albillos, Enrique Rodríguez de Santiago, Fernando Bermejo, Luisa de la Peña, Ana Gutiérrez, Francisco Mesonero, Alicia Algaba, Manuel Van Domselaar, Pilar Nos, Sabino Riestra, Antonio López-Sanromán, Ana García García de Paredes, Adolfo del Val, Andrés Castaño García, Carlos Rodríguez-Escaja, José I. Cameo, Jordi Guardiola, Fernando Gomollón |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Endpoint Determination Endocrinology Diabetes and Metabolism Inflammatory bowel diseases Inflammatory bowel disease Gastroenterology Cohort Studies 03 medical and health sciences 0302 clinical medicine Crohn Disease Recurrence Internal medicine Medicine Humans Survival analysis Retrospective Studies First episode Hepatology business.industry digestive oral and skin physiology Crohn disease Retrospective cohort study Middle Aged medicine.disease Inflammatory Bowel Diseases Ulcerative colitis digestive system diseases body regions Pancreatitis Spain 030220 oncology & carcinogenesis Acute pancreatitis 030211 gastroenterology & hepatology Colitis Ulcerative Female business human activities Cohort study Follow-Up Studies |
| Zdroj: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname PANCREATOLOGY r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
| ISSN: | 1424-3911 1424-3903 |
| Popis: | Background: Idiopathic acute pancreatitis (LAP) in patients with inflammatory bowel disease (IBD) is not well characterized. Our purpose was to better understand this condition and its natural history. Methods: Retrospective cohort study conducted at nine Spanish IBD referral centers. Patients with IBD and a first episode of acute pancreatitis (AP) between 1998 and 2018 were included. Patients with a previous episode of AP or a diagnosis of chronic pancreatitis were excluded. LAP and non-LAP were compared by multivariate logistic regression and survival analysis. Results: We identified 185 patients with IBD (68.7% Crohn's disease) and a first episode of AP. Thirty-eight of those 185 (20.6%) fulfilled criteria for LAP. There were no severe cases of LAP. On multivariate analysis, AP before IBD diagnosis (21.1% vs. 3.4%, p = 0.04) and ulcerative colitis (52.6% vs. 23.1%, p = 0.002) were significantly more common in LAP. Further work-up was performed in 16/38 (42%) LAP patients, and a cause was identified in 6/16 (37.5%). Median time from AP to the end of follow-up was 6.3 years (3.1-10). Five-year risk of AP recurrence was significantly higher in LAP group (28% vs. 5.1%, log-rank p = 0.001), with a median time to first recurrence of 4.4 months (2.9-12.2). Conclusions: LAP represents the second cause of AP in patients with IBD. It is more frequent in ulcerative colitis, and presents a high risk of recurrence. Additional imaging work-up after a first episode of LAP in IBD patients is highly advisable, as it identifies a cause in more than one-third of cases. (C) 2020 LAP and EPC. Published by Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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