Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis

Citation
T. Nakazawa et al., Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis, HEP-GASTRO, 48(39), 2001, pp. 625-630
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
HEPATO-GASTROENTEROLOGY
ISSN journal
0172-6390 → ACNP
Volume
48
Issue
39
Year of publication
2001
Pages
625 - 630
Database
ISI
SICI code
0172-6390(200105/06)48:39<625:APSCCA>2.0.ZU;2-I
Abstract
Background/Aims: We encountered one group of primary sclerosing cholangitis cases which met classic criteria, but demonstrated better clinical courses . Methodology: We evaluated the clinical characteristics of several cases of primary sclerosing cholangitis, especially those associated with chronic pa ncreatitis. Results: Of a total of 25 cases, eight had a background of pancreatitis wit h unusual irregularly segmental or diffuse narrowing features on pancreatog raphy. Abdominal ultrasonography and computed tomography also revealed segm ental or diffuse enlargement of the pancreas. Pathological findings of surg ical specimens in two cases pointed to lymphoplasmacytic sclerosing pancrea titis. The walls of the lower biliary ducts were also thickened with a simi lar appearance to the pancreatic ducts. In seven cases, cholangiography dis played stenosis of the lower part of the common bile duct and in one case, only the hepatic hilar region was affected. In this case both biliary and p ancreatic lesions responded to steroid therapy simultaneously. One case dev eloped hepatic hilar stenosis four months after a lesion in the lower part of the common bile duct had disappeared. The cases of primary sclerosing ch olangitis with pancreatitis demonstrated better clinical courses than did t ypical cases of primary sclerosing cholangitis. Six cases were characterize d by autoimmunological abnormalities. Conclusions: We concluded that similar etiological agents might impact on b oth the pancreas and biliary tract, either simultaneously or in sequence. W e propose new criteria for these atypical primary sclerosing cholangitis ca ses.