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Acute pancreatitis in inflammatory bowel disease, with special reference to azathioprine-induced pancreatitis.

Abstract：

BACKGROUND:Pancreatitis is a potentially severe condition. Patients with inflammatory bowel disease (IBD) seem to be at increased risk for acute pancreatitis. AIM:To describe the incidence, main causes and possible predictive factors of acute pancreatitis in inflammatory bowel disease. METHODS:Information was retrospectively extracted from the clinical records of patients followed in the IBD Units of nine hospitals in Madrid (n = 5073). RESULTS:A total of 82 acute pancreatitis episodes were diagnosed (cumulative incidence, 1.6%); 98% of them were mild. Recurrent acute pancreatitis developed in 13% of patients. Most cases of acute pancreatitis (63.4%) were attributed to drug exposure [azathioprine/mercaptopurine (AZA/MP) n = 46, mesalazine (mesalamine) n = 6]; 20.7% were idiopathic, and 12.2% were biliary. Incidence of acute pancreatitis in patients treated with AZA/MP was 3.1%. In patients with acute pancreatitis, female gender (OR 3.4 95% CI: 1.3-9.3; P = 0.012) and Crohn's disease (CD) (OR 5.8 95% CI: 1.6-20.6; P = 0.007) were risk factors for AZA/MP-associated acute pancreatitis, the latter also when analysed only in patients treated with AZA/MP (n = 1477) (OR 5.2 95% CI: 1.8-14; P = 0.002). CONCLUSIONS:The incidence of acute pancreatitis in our IBD patients (1.6%) is similar to that previously described. Drugs, mainly AZA/MP, are the leading cause. AZA-induced acute pancreatitis is always mild. Patients with CD are at a higher risk for AZA/MP-associated acute pancreatitis. The frequency of idiopathic acute pancreatitis is higher than expected, suggesting that part of these cases could be extraintestinal manifestations of IBD.

journal_name

Aliment Pharmacol Ther

journal_title

Alimentary pharmacology & therapeutics

authors

Bermejo F,Lopez-Sanroman A,Taxonera C,Gisbert JP,Pérez-Calle JL,Vera I,Menchén L,Martín-Arranz MD,Opio V,Carneros JA,Van-Domselaar M,Mendoza JL,Luna M,López P,Calvo M,Algaba A

doi

10.1111/j.1365-2036.2008.03746.x

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

623-8

issue

eissn

0269-2813

issn

1365-2036

pii

APT3746

journal_volume

pub_type

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Acute pancreatitis in inflammatory bowel disease, with special reference to azathioprine-induced pancreatitis.