シミズ　キヨウコ   SHIMIZU Kyoko   清水　京子    所属   その他 その他    職種   非常勤嘱託
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Clinical course of type 1 autoimmune pancreatitis patients without steroid treatment: a Japanese multicenter study of 97 patients.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
巻・号・頁	25(4),pp.223-230
著者・共著者	Kubota Kensuke, Kamisawa Terumi, Hirano Kenji, Hirooka Yoshiki, Uchida Kazushige, Ikeura Tsukasa, Shiomi Hideyuki, Ohara Hirotaka, Shimizu Kyoko, Arakura Norikazu, Kanno Atsushi, Sakagami Junichi, Itoi Takao, Ito Tetsuhide, Ueki Toshiharu, Nishino Takayoshi, Inui Kazuo, Mizuno Nobumasa, Yoshida Hitoshi, Sugiyama Masanori, Iwasaki Eisuke, Irisawa Atsushi, Okazaki Kazuichi, Kawa Shigeyuki, Shimosegawa Toru, Takeyama Yoshifumi, Chiba Tsutomu
発行年月	2018/04
概要	BACKGROUND:Sporadic autoimmune pancreatitis (AIP) cases showing remission without steroid treatment have been reported, however, the clinical course of these patients has not been clarified. This study sought to clarify the clinical course in AIP patients with hesitation for steroid treatment.METHODS:We collected clinical data for AIP patients from high-volume centers in Japan. Data for AIP patients with and those without steroid treatment (steroid treatment vs. wait and see policy or W&S) were then compared. The primary point was the relapse-free survival rate (RFS) in patients with and those without steroid treatment, as determined using Kaplan-Meier curve. The secondary point was the identification of predictors of remission and risks of relapse in AIP patients without steroid treatment.RESULTS:There were 510 AIP patients in the steroid treatment group and 97 patients in the W&S group. Overall, 55.7% (54/97) of type 1 AIP patients in the W&S group experienced transient remission without steroid treatment. The W&S group had a significantly higher patient age and significantly lower incidences of jaundice, diffuse pancreas swelling, proximal-type sclerosing cholangitis, and stent placement and a lower remission rate than the steroid treatment group (each P < 0.05). The RFS reached a plateau at 10 years in both the W&S group (50%) and steroid treatment group (52.9%). As for the RFS (W&S vs. group with steroid), 89.4% vs. 74.4% within 3 years, 81.8% vs. 65.3% within 5 years, and 50% vs. 52.9% within 10 years (log-rank, P = 0.064). Female gender (OR 0.340, P = 0.027) and stent placement for jaundice (OR 4.552, P = 0.008) were identified as predictors of transient remission in the W&S group. New-onset diabetes mellitus (OR 8.333, P = 0.012) and the presence of extensive multi-organ involvement (OR 35, P = 0.006) were identified as risks of relapse in the W&S group.CONCLUSION:Some type 1 AIP patients without steroid treatment experience transient remission. These cases
DOI	10.1002/jhbp.541
PMID	29430861