Clinical Characteristics Of Inflammatory Bowel Disease Associated Pancreatic Disorders

Objectives: To explore the clinical characteristics of pancreatic disorders in patients with inflammatory bowel disease(IBD),and to search for the potential clinical predictors or risk factors of pancreatic disorders in IBD patients.Methods: The IBD patients hospitalized in the Department of Gastroenterology,the First Affiliated Hospital of Fujian Medical University from June 2016 to February2018 were included,and their clinical data were retrospectively analyzed to compare the clinical characteristics between the patients with and without pancreatic disorders,Logistic regression analysis was used to analyze the risk factors of pancreatic disorders,and to explore whether antibodies against exocrine pancreas(PAB)could predict the pancreatic disorders.Last,a literature review was made including the published papers about IBD-associated pancreatic disorders from the establishment of the library to March 1,2018.Results: A total of 114 CD patients with 74 males and 40 females were included,which average age was 28.3 ±11.5 years old(ranged from 9 to 60 years old),and the median disease course was 2 years(15 days to 20 years).Of 114 patients,82 cases were in clinical remission and 32 in active stage.Nine patients(7.9%)fulfilled the diagnostic criteria of pancreatic disorders,of which 4(4.9%)cases were CD in remission,5(15.6%)cases in active stage.The prevalence of pancreatic disorders was no significant difference between these two groups(?2=2.327,P=0.127).The univariate analyses showed that age with ? 50 years old(r=0.302,P=0.001),and positive seral antibodies against gobletcells(GAB)-Ig G(r=0.277,P=0.008)were positively correlated with the prevalence rates of pancreatic disorders respectivly.And biologics admidistration showed a negative correlation with the prelavence of pancreatic disorders(r=0.203,P=0.031).A multivariate Logistic regression analysis suggested that age with?50 years old was a only risk factor for pancreatic disorders in IBD(OR=26.000,95%CI: 2.011~336.107).There was no a significant difference between the detection rates of pancreatic disorders in PAB positive IBD patients(3.4%)and in the PAB negative patients(11.4%)(P > 0.05),The results suggest that PAB is not enough to indicate pancreatic disorders.In the literature review,32 articles met the criteria were included.Of the all 79 cases of IBD-associated pancreatic disorders reported in these articles,43 cases were male and 22 female,with a mean age of(32.4±15.0)years old.And 51 cases(71.8%)were patients with CD,the another 20(28.2%)with UC.Thirty-three patients(41.8%)had acute pancreatitis,29(36.7%)chronic pancreatitis,5(6.3%)autoimmune pancreatitis.Abdominal pain was one of the main clinical manifestation in 57 cases.And on pancreatic imaging,pancreatic enlargement(20.3%)was the main manifestation,followed by pancreatic duct dilatation(8.9%)and pancreatic space-occupying lesions(6.3%).The most of pancreatic disorders occurred after the diagnosis of IBD and often showed a mild progress and a good prognosis.Conclusion: Pancreatic disorders were no really rare in IBD patients,which common type was acute pancreatitis.Patient's Age?50 years old was the risk factor of IBD associated pancreatic disorders.However,the further prospective studies are needed.