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Duct-Narrowing Chronic Pancreatitis Without Immunoserologic Abnormality: Comparison with Duct-Narrowing Chronic Pancreatitis with Positive Serological Evidence and Its Clinical Management

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Abstract

We reviewed the clinical features and clinical course of patients with duct-narrowing chronic pancreatitis who were negative for immunoserologic test results (n = 16) in comparison with the findings for serological test-positive patients (n = 20) in order to determine an adequate treatment for those who had typical morphology of autoimmune pancreatitis in the absence of immunoserologic abnormality. No significant differences were found between the two groups of patients in clinical profiles including associated autoimmune-related diseases, pancreatic histology, and response to steroid therapy. Of the seronegative patients, eight who showed an improvement in narrowing of the main pancreatic duct with steroid therapy and three who did no show an improvement or who relapsed after surgical resection without this therapy had stenosis of the common bile duct with increased levels of serum hepatobiliary enzymes, except for two patients with affected sites limited to the body or tail of the gland. For the remaining five patients, who showed an improvement in pancreatic duct changes or long-term remission after surgery without steroid administration, normal biochemistry test results for liver functions were obtained, with no abnormal cholangiographic findings in the three patients examined. Duct-narrowing chronic pancreatitis without immunoserologic abnormality overlaps in clinical features with that fulfilling the immunoserologic criteria for a diagnosis of autoimmune pancreatitis. In particular, the disease with bile duct involvement should be treated clinically as autoimmune pancreatitis, for which steroid therapy is recommended, even if an autoimmune mechanism is not demonstrated serologically.

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Authors and Affiliations

  1. Department of Gastroenterology and Surgery, Saisekai Kanazawa Hospital, Kanazawa

    Tokio Wakabayashi MD, Yukimitsu Kawaura MD, Yoshitake Satomura MD, Takeshi Urabe MD, Hiroyuki Watanabe MD, Yoshiharu Motoo MD & Norio Sawabu MD

  2. Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama

    Tokio Wakabayashi MD, Yukimitsu Kawaura MD, Yoshitake Satomura MD, Takeshi Urabe MD, Hiroyuki Watanabe MD, Yoshiharu Motoo MD & Norio Sawabu MD

  3. Department of Gastroenterology, Public Central Hospital, Ishikawa, Matto

    Tokio Wakabayashi MD, Yukimitsu Kawaura MD, Yoshitake Satomura MD, Takeshi Urabe MD, Hiroyuki Watanabe MD, Yoshiharu Motoo MD & Norio Sawabu MD

  4. Department of Internal Medicine and Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan

    Tokio Wakabayashi MD, Yukimitsu Kawaura MD, Yoshitake Satomura MD, Takeshi Urabe MD, Hiroyuki Watanabe MD, Yoshiharu Motoo MD & Norio Sawabu MD

  5. Department of Gastroenterology, Saisekai Kanazawa Hospital, Akatsuchi-machi Ni 13-6, Kanazawa, 920-0353, Japan

    Tokio Wakabayashi MD

Authors
  1. Tokio Wakabayashi MD
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  2. Yukimitsu Kawaura MD
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  3. Yoshitake Satomura MD
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  4. Takeshi Urabe MD
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  5. Hiroyuki Watanabe MD
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  6. Yoshiharu Motoo MD
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  7. Norio Sawabu MD
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Correspondence to Tokio Wakabayashi MD.

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Wakabayashi, T., Kawaura, Y., Satomura, Y. et al. Duct-Narrowing Chronic Pancreatitis Without Immunoserologic Abnormality: Comparison with Duct-Narrowing Chronic Pancreatitis with Positive Serological Evidence and Its Clinical Management. Dig Dis Sci 50, 1414–1421 (2005). https://doi.org/10.1007/s10620-005-2855-7

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  • DOI: https://doi.org/10.1007/s10620-005-2855-7

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