Evaluation of pancreatic endocrine and exocrine function in patients with autoimmune pancreatitis

Tetsuhide Ito, Ken Kawabe, Yoshiyuki Arita, Terumasa Hisano, Hisato Igarashi, Akihiro Funakoshi, Toshihiko Sumii, Takeharu Yamanaka, Ryoichi Takayanagi

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

OBJECTIVES: Up to now, the characteristics of pancreatic endocrine and exocrine functions in autoimmune pancreatitis (AIP) are still unclear. The aim of this study is to evaluate pancreatic functions in AIP compared with those of chronic pancreatitis (CP). METHODS: Twelve patients with AIP and 25 patients with CP were examined for exocrine and endocrine pancreas. Exocrine function was evaluated by a secretin test. Concerning endocrine function, insulin secretion (C-peptide response) was examined with the glucagon tolerance test and glucagon secretion was examined with the arginine tolerance test. Pathological examination of pancreatic tissues was done on the operative specimens of AIP and CP that could not be clinically excluded from pancreatic cancer. RESULTS: For the secretin test, 8.3% of patients with AIP showed 1-factor abnormality, which was a reduction in volume, and 41.7% showed 2-factor abnormalities, which were a reduction in volume and amylase output. On the other hand, 44.0% of patients with CP showed only 1-factor abnormality, which was the reduction in the maximum bicarbonate concentration. Autoimmune pancreatitis accompanied with diabetes mellitus showed a reduction both in ΔC-peptide response (β-cell response) and Δglucagon (α-cell response). Histologically, AIP showed lymphoplasmatic cells infiltration surrounding the pancreatic ducts, but basement membranes were intact. Moreover, basement membranes of the duct were injured in CP. Furthermore, islet cells in AIP were revealed as almost intact even though they were surrounded by fibrosis. CONCLUSIONS: These findings indicate that exocrine dysfunction with AIP is different from CP because AIP induces stenosis of the pancreatic ducts, but ductal cells that possess the function of bicarbonate secretion are intact, and that endocrine dysfunction with AIP was secondary pancreatic diabetes.

Original languageEnglish
Pages (from-to)254-259
Number of pages6
JournalPancreas
Volume34
Issue number2
DOIs
Publication statusPublished - Mar 1 2007

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Pancreatitis
Chronic Pancreatitis
Glucagon
Secretin
C-Peptide
Pancreatic Ducts
Bicarbonates
Islets of Langerhans
Basement Membrane
Exocrine Pancreas
Amylases
Pancreatic Neoplasms
Arginine
Diabetes Mellitus
Pathologic Constriction
Fibrosis
Insulin

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

Ito, T., Kawabe, K., Arita, Y., Hisano, T., Igarashi, H., Funakoshi, A., ... Takayanagi, R. (2007). Evaluation of pancreatic endocrine and exocrine function in patients with autoimmune pancreatitis. Pancreas, 34(2), 254-259. https://doi.org/10.1097/01.mpa.0000250127.18908.38

Evaluation of pancreatic endocrine and exocrine function in patients with autoimmune pancreatitis. / Ito, Tetsuhide; Kawabe, Ken; Arita, Yoshiyuki; Hisano, Terumasa; Igarashi, Hisato; Funakoshi, Akihiro; Sumii, Toshihiko; Yamanaka, Takeharu; Takayanagi, Ryoichi.

In: Pancreas, Vol. 34, No. 2, 01.03.2007, p. 254-259.

Research output: Contribution to journalArticle

Ito, T, Kawabe, K, Arita, Y, Hisano, T, Igarashi, H, Funakoshi, A, Sumii, T, Yamanaka, T & Takayanagi, R 2007, 'Evaluation of pancreatic endocrine and exocrine function in patients with autoimmune pancreatitis', Pancreas, vol. 34, no. 2, pp. 254-259. https://doi.org/10.1097/01.mpa.0000250127.18908.38
Ito, Tetsuhide ; Kawabe, Ken ; Arita, Yoshiyuki ; Hisano, Terumasa ; Igarashi, Hisato ; Funakoshi, Akihiro ; Sumii, Toshihiko ; Yamanaka, Takeharu ; Takayanagi, Ryoichi. / Evaluation of pancreatic endocrine and exocrine function in patients with autoimmune pancreatitis. In: Pancreas. 2007 ; Vol. 34, No. 2. pp. 254-259.
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AU - Igarashi, Hisato

AU - Funakoshi, Akihiro

AU - Sumii, Toshihiko

AU - Yamanaka, Takeharu

AU - Takayanagi, Ryoichi

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AB - OBJECTIVES: Up to now, the characteristics of pancreatic endocrine and exocrine functions in autoimmune pancreatitis (AIP) are still unclear. The aim of this study is to evaluate pancreatic functions in AIP compared with those of chronic pancreatitis (CP). METHODS: Twelve patients with AIP and 25 patients with CP were examined for exocrine and endocrine pancreas. Exocrine function was evaluated by a secretin test. Concerning endocrine function, insulin secretion (C-peptide response) was examined with the glucagon tolerance test and glucagon secretion was examined with the arginine tolerance test. Pathological examination of pancreatic tissues was done on the operative specimens of AIP and CP that could not be clinically excluded from pancreatic cancer. RESULTS: For the secretin test, 8.3% of patients with AIP showed 1-factor abnormality, which was a reduction in volume, and 41.7% showed 2-factor abnormalities, which were a reduction in volume and amylase output. On the other hand, 44.0% of patients with CP showed only 1-factor abnormality, which was the reduction in the maximum bicarbonate concentration. Autoimmune pancreatitis accompanied with diabetes mellitus showed a reduction both in ΔC-peptide response (β-cell response) and Δglucagon (α-cell response). Histologically, AIP showed lymphoplasmatic cells infiltration surrounding the pancreatic ducts, but basement membranes were intact. Moreover, basement membranes of the duct were injured in CP. Furthermore, islet cells in AIP were revealed as almost intact even though they were surrounded by fibrosis. CONCLUSIONS: These findings indicate that exocrine dysfunction with AIP is different from CP because AIP induces stenosis of the pancreatic ducts, but ductal cells that possess the function of bicarbonate secretion are intact, and that endocrine dysfunction with AIP was secondary pancreatic diabetes.

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