Abstract
Autoimmune pancreatitis is a unique form of chronic pancreatitis and has been correlated with various extrapancreatic lesions. To search for a correlation between autoimmune pancreatitis and thyroid lesions, we measured thyroid functions in 41 patients with autoimmune pancreatitis and in 41 patients with chronic calcifying pancreatitis and investigated the correlation between HLA antigens and hypothyroidism. We found a significant difference in the prevalence of antithyroglobulin antibody and hypothyroidism between patients with autoimmune pancreatitis and those with chronic pancreatitis (34.1 vs. 7.3%, P = 0.005, and 26.8 vs. 0%, P = 0.0005, respectively). Patients with hypothyroidism had a significantly higher frequency of antithyroglobulin antibody (63.6%) than those without hypothyroidism but showed no differences in other findings, including serum IgG4 concentration. We could find no significant association between any HLA antigens and the hypothyroid state of autoimmune pancreatitis. One quarter of the patients with autoimmune pancreatitis have hypothyroidism that may be independent of the active state of the pancreatic lesion or systemic fibrosing disorder, and thus patients suspected of having autoimmune pancreatitis should be evaluated for possible hypothyroidism.
Similar content being viewed by others
Refrences
Sarles H, Sarles JC, Muratore R, Guien C: Chronic inflammatory sclerosis of the pancreas- an autonomous pancreatitis disease? Am J Dig Ds 6:688–698, 1961
Yoshida K, Toki F, Takeuchi T, Watanabe S, Shiratori K, Hayashi N: Chronic pancreatitis caused by an autoimmune abnormality, proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 40:1561–1568, 1995
Horiuchi A, Kaneko T, Yamamura N, Nagata A, Nakamura T, Akamatsu T, Mukawa K, Kawa S, Kiyosawa K: Autoimmune pancreatitis simulating pancreatic lymphoma. Am J Gastroenterol 91:2607–2609, 1996
Ito T, Nakano I, Koyanagi S, Miyahara T, Migita Y, Ogoshi K, Sakai H, Matsunaga S, Yasuda O, Sumii T, Nawata H: Autoimmune pancreatitis as a new clinical entity, three cases of autoimmune pancreatitis with effective steroid therapy. Dig Dis Sci 42:1458–1468, 1997
Horiuchi A, Kawa S, Akamatsu T, Aoki Y, Mukawa K, Furuya N, Ochi Y, Kiyosawa K: Characteristic pancreatic duct appearance in autoimmune chronic pancreatitis: a case report and review of the Japanese literature. Am J Gastroenterol 93:260–263, 1998
Motoo Y, Minamoto T, Watanabe H, Sakai J, Okai T, Sawabu N: Sclerosing pancreatitis showing rapidly progressive changes with recurrent mass formation. Int J Pancreatol 21:85–90, 1997
Wakabayashi T, Motoo Y, Kojima Y, Makino H, Sawabu N: Chronic pancreatitis with diffuse irregular narrowing of the main pancreatic duct. Dig Dis Sci 43:2415–2425, 1998
Erkelens GW, Vleggar FP, Lesterhuis W, van Buuren HR, van der Werf SD: Sclerosing pancreatico-cholangitis responsive to steroid therapy. Lancet 354:43–44, 1999
Horiuchi A, Kawa S, Hamano H, Ochi Y, Kiyosawa K: Sclerosing pancreato-cholangitis responsive to corticosteroid therapy: report of 2 case reports and review. Gastrointest Endosc 53:518–522, 2001
Okazaki K, Chiba T: Autoimmune related pancreatitis. Gut 51:1–4, 2002
Horiuchi A, Kawa S, Hamano H, Hayama M, Ota H, Kiyosawa K: ERCP features in 27 patients with autoimmune pancreatitis. Gastrointest Endosc 55:494–499, 2002
Hamano H, Kawa S, Horiuchi A, Unno H, Furuya N, Akamatsu T, Fukushima M, Nikaido T, Nakayama K, Usuda N, Kiyosawa K: High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 344:732–738, 2001
Kawa S, Ota M, Yoshizawa K, Horiuchi A, Hamano H, Ochi Y, Nakayama K, Tokutake Y, Katsuyama Y, Saito S, Hasebe O, Kiyosawa K: HLA DRB10405-DQB10401 haplotype is associated with autoimmune pancreatitis in the Japanese population. Gastroenterology 122:1264–1269, 2002
Kamisawa T, Tu Y, Egawa N, Sakaki N, Inokuma S, Kamata N: Salivary gland involvement in chronic pancreatitis of various etiologies. Am J Gastroenterol 98:323–326, 2003
Kawaguchi K, Koike M, Tsuruta K, Okamoto A, Tobata I, Fujita N: Lymphoplasmacytic sclerosing pancreatitis with cholangitis: a variant of primary sclerosing cholangitis extensively involving pancreas. Hum Pathol 22:387–395, 1991
Hamano H, Kawa S, Ochi Y, Unno H, Shiba N, Wajiki M, Nakazawa K, Shimojo H, Kiyosawa K: Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis. Lancet 359:1403–1404, 2002
Comings DE, Skubi KB, Van Eyes J, Motulsky AG: Familial multifocal fibrosclerosis. Findings suggesting that retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, Riedel’s thyroiditis, and pseudotumor of the orbit may be different manifestations of a single disease. Ann Intern Med 66:884–892, 1967
Clark A, Zeman RK, Choyke PL, White EM, Burrell MI, Grant EG, Jaffe MH: Pancreatic pseudotumors associated with multifocal idiopathic fibrosclerosis. Gastrointest Radiol 13:30–32, 1988
Saito S, Ota S, Yamada E, Inoko H, Ota M: Allele frequencies and haplotype associations defined by allelic typing at HLA class I and class II loci in the Japanese population. Tissue Antigens 56:522–529, 2000
Honda K, Tamai H, Morita T, Kuma K, Nishimura Y, Sasazuki T: Hashimoto’s thyroiditis and HLA in Japan. J Clin Endocrinol Metab 69:1268–1273, 1989
Klein J, Sato A: The HLA system, second of two parts. N Engl J Med 343:782–786, 2000
Perez B, Kraus A, Lopez G, Cifuentes M, Alarcon-Segovia D: Autoimmune thyroid disease in primary Sjögren’s syndrome. Am J Med 99:480–484, 1995
Pyne D, Isenberg DA: Autoimmune thyroid disease in systemic lupus erythematosus. Ann Rheum Dis 61:70–72, 2002
Larsen PR, Davies TF: Hypothyroidism and thyroiditis. In Textbook of Endocrinology. Larsen PR, Kronenberg HM, Melmed S, Polonsky KS (eds). Philadelphia, Saunders, 2002, pp 423–455
Elta GH, Sepersky RA, Goldberg MJ, Connors CM, Miller KB, Kaplan MM: Increased incidence of hypothyroidism in primary biliary cirrhosis. Dig Dis Sci 28:971–975, 1983
Saarinen S, Olerup O, Broome U: Increased frequency of autoimmune diseases in patients with primary sclerosing cholangitis. Am J Gastroenterol 95:3195–3199, 2000
Abraham SC, Wilentz RE, Yeo CJ, Sohn TA, Cameron JL, Boitnott JK, Hruban RH: Pancreaticoduodenectomy (Whipple resections) in patients without malignancy: Are they all ‘chronic pancreatitis’? Am J Surg Pathol 27:110–120, 2003
Spencer CA, Takeuchi M, Kazarosyan M, Wang CC, Guttler RB, Singer PA, Fatemi S, LoPresti JS, Nicoloff JT: Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma. J Clin End ocrinol Metab 83:1121–1127, 1998
Igawa T, Nakabayashi H, Takeda R, Kurata Y: A possible common cell surface autoantigen in islet beta-cells and thyroid follicular cells in patients with non-insulin dependent diabetes mellitus and chronic thyroiditis. Endocr J 43:299–306, 1996
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Komatsu, K., Hamano, H., Ochi, Y. et al. High Prevalence of Hypothyroidism in Patients with Autoimmune Pancreatitis. Dig Dis Sci 50, 1052–1057 (2005). https://doi.org/10.1007/s10620-005-2703-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-005-2703-9