Autoimmune Pancreatitis: Long-term Outcome

Autoimmune pancreatitis (AIP) is a distinct type of chronic pancreatitis (CP),
which predominantly affects males in their fifth and sixth decades. AIP
presents clinically as obstructive jaundice and less frequent with steatorrhea,
diabetes mellitus and various extrapancreatic manifestations. This disease has
several characteristic radiological features including diffuse enlargement of
the pancreas and irregular narrowing of the main pancreatic duct which may be
present but are not obligatory. Laboratory tests often reveal elevated serum
levels of IgG, IgG4 and the presence of autoantibodies, but not in all cases.
Steroids have to shown to be a highly effective therapy for AIP.4, 7-9 However,
following steroid tapering or cessation, relapses are observed frequently
(6-55%).10-12
Inflammation of the pancreas during an extended period can result in
substantial fibrosis of the pancreas, causing permanent damage. This is
frequently resulting in endocrine and/or exocrine insufficiency of the
pancreas.
Until now, long-term outcome has been described in relatively small series with
a limited follow-up period. Especially the outcome with focus on pancreatic
exocrine and endocrine function has been scarcely described in only
retrospective series which are presumably subject to bias.

The objective of the study is to investigate the long-term clinical outcome of
AIP with a minimum follow-up of two years.

This is a prospective, cross-sectional study.

Burden:
Participation in this study requires withdrawal of blood and collection of a
small amount of feces, both will take place once. The withdrawal of blood can
take place during a routine visit at the attending gastroenterologist, so the
subject will not have to travel far. If the patient does not have an
appointment with the attending gastroenterologist, the principal investigator
can visit the patient at home to withdraw the blood sample.
Feces will be send by mail, in a box which will be sent to the subject by us.
The subject will be asked to complete 2 questionaires concerning quality of
life, and 1 questionaire concerning the course of the disease (AIP). This will
take 1-1.5 hours. The questionaires will be send by mail, including a
self-adressed envelope, with which the subject can return the questionaires.

Risks:
Withdrawal of blood can result in little pain, swelling and/or infection or a
bruise. The collection of feces is not related with any risk.