Clinical course of ulcerative colitis patients who develop acute pancreatitis

Table 1 Baseline characteristics of ulcerative colitis patients who developed autoimmune pancreatitis and aminosalicylate-induced pancreatitis, each compared with non-pancreatitis ulcerative colitis patients n (%)

Variable	Autoimmune pancreatitis (n = 13)	P value vs no pancreatitis	Aminosalicylate-induced (n = 10)	P value vs no pancreatitis	No pancreatitis (n = 3256)
Male gender	9 (69.2)	0.223	8 (80.0)	0.125	1788 (54.9)
Age at diagnosis of UC, years, median (range)	22.9 (14.9-42.8)	0.001	31.7 (15.7-67.3)	0.444	36.4 (9.0-90.5)
Smoking status at diagnosis of UC		0.876		0.876
Never smoked	8 (61.5)		6 (60)		1870 (57.5)
Ex-smoker	2 (15.4)		3 (30)		706 (21.7)
Current smoker	3 (23.1)		1 (10)		557 (17.1)
Not documented	0		0		121 (3.7)
Disease extent at diagnosis of UC, n (%)		0.012		< 0.001
Proctitis	0		0		1381 (42.4)
Left-sided	6 (46.2)		0		862 (26.5)
Extensive	6 (46.2)		9 (90)		711 (21.8)
Not documented	1 (7.6)		1 (10)		302 (9.3)
Follow-up duration after UC diagnosis, mo, median (range)	48.3 (3.2-150.9)		97.2 (12.4-187.6)		87.2 (0.2-455.5)
Follow-up duration after pancreatitis diagnosis, mo, median (range)	27.8 (3.2-81.9)		91.6 (10.7-174.8)

NA: Not applicable; UC: Ulcerative colitis.

Table 2 Diagnosis of autoimmune pancreatitis

Patient	Imaging	IDCP			ERP			Rt	Definitive/probable
		1H	2H	Negative	1D	2D	Negative
1	Typical			+	+			+	Probable
2	Typical	+			+			+	Definitive
3	Indeterminate			+	+			+	Probable
4	Typical	+			+			+	Definitive
5	Typical			+	+			+	Probable
6	Typical			+		+		+	Probable
7	Typical	+				+		+	Definitive
8	Typical			+			+	+	Probable
9	Typical			+		+		+	Probable
10	Indeterminate			+	+			+	Probable
11	Typical	+			+			+	Definitive
12	Indeterminate		+			+		+	Probable
13	Indeterminate			+			+	+	Probable

D: Ductal imaging on ERP; ERP: Endoscopic retrograde pancreatography; H: Histology of the pancreas; IDCP: Idiopathic duct centric pancreatitis; Rt: Response to steroid, i.e., rapid (< 2 wk) radiologically demonstrable resolution or marked improvement in manifestations.

Table 3 Comparison of baseline characteristics in ulcerative colitis patients who developed thiopurine-induced pancreatitis and non-pancreatitis ulcerative colitis patients n (%)

Variable	Thiopurine-induced pancreatitis (n = 13)	No pancreatitis (n = 704)1	P value
Male gender	4 (30.8)	434 (61.7)	0.040
Age at diagnosis of UC, yr, median (range)	37.9 (12.1-57.3)	34.8 (11.4-75.9)	0.667
Smoking status at diagnosis of UC			0.576
Never smoked	10 (76.9)	405 (57.6)
Ex-smoker	2 (15.4)	168 (23.9)
Current smoker	1 (7.7)	125 (17.8)
Not documented	0	5 (0.7)
Disease extent at diagnosis of UC			0.837
Proctitis	2 (15.4)	167 (23.7)
Left-sided	3 (23.1)	167 (23.7)
Extensive	6 (46.1)	232 (33.0)
Not documented	2 (15.4)	138 (19.6)
Follow-up duration after UC diagnosis, mo, median (range)	42.9 (10.7-169.2)	91.5 (0.3-356.3)	0.008
Follow-up duration after pancreatitis diagnosis, mo, median (range)	21.0 (0.3-89)

¹Non-pancreatitis UC patients who had taken thiopurines. NA: Not applicable; UC: Ulcerative colitis.

Table 4 Odds ratios for anti-tumor necrosis factor use during follow-up according to cause of acute pancreatitis, adjusted for baseline disease extent of ulcerative colitis

Cause of pancreatitis	n	OR (95%CI)	P value
No pancreatitis (reference)	3256	1.00
Autoimmune	11	0.84 (0.11-6.66)	0.873
No pancreatitis (reference)1	3256	1.00
Aminosalicylate-induced	10	5.16 (1.42-18.67)	0.012
No pancreatitis (reference)1	704	1.00
Thiopurine-induced	12	6.90 (1.83-25.98)	0.004

¹Non-pancreatitis patients (reference) who were treated with either aminosalicylates or thiopurines. Patients who had been on anti-TNF before diagnosis of pancreatitis were excluded (n = 3). UC: Ulcerative colitis.

Table 5 Odds ratios for colectomy according to cause of acute pancreatitis, adjusted for baseline disease extent of ulcerative colitis

Cause of pancreatitis	n	OR (95%CI)	P value
No pancreatitis (reference)	3256	1.00
Autoimmune	13	1.65 (0.35-7.66)	0.525
No pancreatitis (reference)1	3256	1.00
Aminosalicylate-induced	10	1.76 (0.67-8.41)	0.480
No pancreatitis (reference)1	704	1.00
Thiopurine-induced	13	1.31 (0.32-6.60)	0.651

¹Non-pancreatitis patients (reference) who were treated with either aminosalicylates or thiopurines. Among 3307 UC patients, those with biliary pancreatitis (n = 6) and idiopathic pancreatitis (n = 9) were excluded from the analysis, and the results from the remaining 3292 are shown. UC: Ulcerative colitis.