Clinical characteristics and long-term prognosis of autoimmune pancreatitis with renal lesions

Abstract Autoimmune pancreatitis (AIP) is recognized as the pancreatic manifestation of a systemic IgG4-related disease that can involve various organs, including the kidney. However, renal lesions tend to be overlooked when AIP is diagnosed, and the clinical characteristics and long-term prognosis...

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Autores principales: Takuya Ishikawa, Hiroki Kawashima, Eizaburo Ohno, Tadashi Iida, Hirotaka Suzuki, Kota Uetsuki, Jun Yashika, Kenta Yamada, Masakatsu Yoshikawa, Noriaki Gibo, Toshinori Aoki, Kunio Kataoka, Hiroshi Mori, Takeshi Yamamura, Kazuhiro Furukawa, Masanao Nakamura, Yoshiki Hirooka, Mitsuhiro Fujishiro
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/e33cdd3707f44fb79ddeacaa58ac8de5
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Sumario:Abstract Autoimmune pancreatitis (AIP) is recognized as the pancreatic manifestation of a systemic IgG4-related disease that can involve various organs, including the kidney. However, renal lesions tend to be overlooked when AIP is diagnosed, and the clinical characteristics and long-term prognosis of AIP with renal lesions are unclear. We retrospectively reviewed 153 patients with AIP diagnosed at our hospital with a median follow-up period of 41 months (interquartile range, 10–86) and classified them into two groups: the KD group (n = 17), with characteristic renal imaging features, and the non-KD group (n = 136). Serum IgG4 levels were significantly higher in the KD group (663 vs. 304.5 mg/dl, P = 0.014). No differences were observed between the two groups in terms of steroid treatment [14/17 (82.4%) vs. 112/136 (82.4%), P = 1] or in the number of patients who exhibited exacerbation of renal function during treatment [1/17 (5.9%) vs. 8/136 (5.9%), P = 1]. However, the cumulative relapse rate was significantly higher in the KD group [61% vs. 21.9% (3 years), P < 0.001]. Patients in the KD group had different clinical features with high relapse rates compared with those in the non-KD group, and thus, it is important to confirm the presence of renal lesions in AIP patients.