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Sung Wook Hwang, Jong Wook Kim, Sang Hyoung Park, Ho-Su Lee, Byong Duk Ye, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, P-109 Clinical Course of Ulcerative Colitis Patients Who Developed Acute Pancreatitis in a Large Korean Cohort, Inflammatory Bowel Diseases, Volume 23, Issue suppl_1, February 2017, Pages S39–S40, https://doi.org/10.1097/01.MIB.0000512628.62712.6b
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Clinical course of patients with ulcerative colitis (UC) who developed pancreatitis is not well known.
Medical records of 3307 UC patients who visited Asan Medical Center from June 1989 to May 2015 were reviewed.
Among 51 patients who developed acute pancreatitis, there were 13 autoimmune (0.40%), 10 aminosalicylate-induced (0.30%), and 13 (1.73%) cases of thiopurine-induced pancreatitis. Patients with autoimmune pancreatitis (AIP) had type II AIP (2 definitive and 11 probable), and baseline extent of UC was left-sided in 5 and extensive in 6 (unknown in one). Median time to development of acute pancreatitis was 749 days (interquartile range [IQR], 4–1552), 50 days (IQR, 24–154 d), and 18 days (IQR, 8–30 d) after diagnosis of UC for autoimmune, aminosalicylate-induced, and thiopurine-induced pancreatitis, respectively. Two patients had autoimmune pancreatitis before diagnosis of UC. Incidence of autoimmune, aminosalicylate-induced, and thiopurine-induced pancreatitis were 0.36 (95% CI, 0.19–0.66), 0.28 (95% CI, 0.14–0.57), and 3.91 (95% CI, 2.27–6.74) per 1000 person-years, respectively. All patients with pancreatitis recovered uneventfully, and there was no case of recurrent pancreatitis. Colectomy rates for autoimmune, ASA-induced, thiopurine-induced pancreatitis and non-pancreatitis patients were 15.4% (2/13), 20% (2/10), 15.4% (2/12), and 7.3% (239/3256), respectively (P = 0.085). Subsequent use of anti-TNF was significantly higher with thiopurine-induced pancreatitis (adjusted HR, 10.95; 95% CI, 4.80–25.0) compared to those without pancreatitis.
Although patients with pancreatitis had more extensive disease, clinical course of UC did not differ significantly compared to that of non-pancreatitis patients.
