Clinical course of patients with ulcerative colitis (UC) who developed pancreatitis is not well known.Methods:
Medical records of 3307 UC patients who visited Asan Medical Center from June 1989 to May 2015 were reviewed.Results:
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.Conclusions:
Although patients with pancreatitis had more extensive disease, clinical course of UC did not differ significantly compared to that of non-pancreatitis patients.