Korean J Gastroenterol.  2006 Aug;48(2):104-111.

Comparison of Clinical Findings between Autoimmune Pancreatitis with Bile Duct Involvement and Primary Sclerosing Cholangitis

• Kim JY
• Kim MH
• Jung JH
• Song JH
• Oh HC
• Kwon SH
• Lee TY
• Lee SS
• Seo DW
• Lee SK

Abstract

BACKGOUND/AIMS: The involvement of bile ducts is frequently reported in autoimmune pancreatitis (AIP), which seem to have similar features to primary sclerosing cholangitis (PSC). Recent systematic comparative studies about these diseases are rare in Korea. METHODS: We retrospectively analyzed 26 patients with AIP with bile duct involvement and 30 patients with classic PSC who were diagnosed during the last decade. RESULTS: The mean age of patients was significantly higher in AIP than PSC at the time of diagnosis. There was a preponderance of men in both group, which was more prominent in AIP. The most common symptom in patients with AIP was jaundice, but PSC patients usually visited hospitals due to incidentally detected abnormal liver function tests. Most (26/31) of AIP had bile duct involvement. All of these patients showed narrowing of intrapancreatic common bile ducts and one patient exhibited hilar involvement as well. About 80% of PSC had both intra- and extrahepatic ducts involvement, and the characteristic features involve multifocal strictures. AIP patients showed improvement with steroid treatment, however, most PSC patients showed clinical deterioration. CONCLUSIONS: The clinical and cholangiographic findings of patients with AIP and PSC have many different characteristics. Therefore, further study of two diseases is required for the proper diagnosis and management.

Keyword

Autoimmune pancreatitis; Primary sclerosing cholangitis; Cholangiopancreatography, endoscopic retrograde

MeSH Terms

Autoimmune Diseases/*diagnosis/pathology/radiography
Bile Ducts/pathology
*Cholangiography
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis, Sclerosing/*diagnosis/pathology/radiography
Diagnosis, Differential
Female
Humans
Immunoglobulins/blood
Male
Pancreatitis/*diagnosis/*immunology/pathology
Retrospective Studies
Sex Factors