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Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis.
Hepatogastroenterology 2001 May-Jun; 48(39):625-30H

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 pancreatitis.

RESULTS

Of a total of 25 cases, eight had a background of pancreatitis with unusual irregularly segmental or diffuse narrowing features on pancreatography. Abdominal ultrasonography and computed tomography also revealed segmental or diffuse enlargement of the pancreas. Pathological findings of surgical specimens in two cases pointed to lymphoplasmacytic sclerosing pancreatitis. The walls of the lower biliary ducts were also thickened with a similar appearance to the pancreatic ducts. In seven cases, cholangiography displayed 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 pancreatic lesions responded to steroid therapy simultaneously. One case developed hepatic hilar stenosis four months after a lesion in the lower part of the common bile duct had disappeared. The cases of primary sclerosing cholangitis with pancreatitis demonstrated better clinical courses than did typical cases of primary sclerosing cholangitis. Six cases were characterized by autoimmunological abnormalities.

CONCLUSIONS

We concluded that similar etiological agents might impact on both the pancreas and biliary tract, either simultaneously or in sequence. We propose new criteria for these atypical primary sclerosing cholangitis cases.

Authors+Show Affiliations

First Department of Internal Medicine, Nagoya City University Medical School, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11462890

Citation

Nakazawa, T, et al. "Atypical Primary Sclerosing Cholangitis Cases Associated With Unusual Pancreatitis." Hepato-gastroenterology, vol. 48, no. 39, 2001, pp. 625-30.
Nakazawa T, Ohara H, Yamada T, et al. Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis. Hepatogastroenterology. 2001;48(39):625-30.
Nakazawa, T., Ohara, H., Yamada, T., Ando, H., Sano, H., Kajino, S., ... Itoh, M. (2001). Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis. Hepato-gastroenterology, 48(39), pp. 625-30.
Nakazawa T, et al. Atypical Primary Sclerosing Cholangitis Cases Associated With Unusual Pancreatitis. Hepatogastroenterology. 2001;48(39):625-30. PubMed PMID: 11462890.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis. AU - Nakazawa,T, AU - Ohara,H, AU - Yamada,T, AU - Ando,H, AU - Sano,H, AU - Kajino,S, AU - Hashimoto,T, AU - Nakamura,S, AU - Ando,T, AU - Nomura,T, AU - Joh,T, AU - Itoh,M, PY - 2001/7/21/pubmed PY - 2002/1/17/medline PY - 2001/7/21/entrez SP - 625 EP - 30 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 48 IS - 39 N2 - 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 pancreatitis. RESULTS: Of a total of 25 cases, eight had a background of pancreatitis with unusual irregularly segmental or diffuse narrowing features on pancreatography. Abdominal ultrasonography and computed tomography also revealed segmental or diffuse enlargement of the pancreas. Pathological findings of surgical specimens in two cases pointed to lymphoplasmacytic sclerosing pancreatitis. The walls of the lower biliary ducts were also thickened with a similar appearance to the pancreatic ducts. In seven cases, cholangiography displayed 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 pancreatic lesions responded to steroid therapy simultaneously. One case developed hepatic hilar stenosis four months after a lesion in the lower part of the common bile duct had disappeared. The cases of primary sclerosing cholangitis with pancreatitis demonstrated better clinical courses than did typical cases of primary sclerosing cholangitis. Six cases were characterized by autoimmunological abnormalities. CONCLUSIONS: We concluded that similar etiological agents might impact on both the pancreas and biliary tract, either simultaneously or in sequence. We propose new criteria for these atypical primary sclerosing cholangitis cases. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/11462890/Atypical_primary_sclerosing_cholangitis_cases_associated_with_unusual_pancreatitis_ L2 - http://www.diseaseinfosearch.org/result/5961 DB - PRIME DP - Unbound Medicine ER -