caa a22 4500 445889039 CHVBK 20180317145609.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00535-010-0361-y doi (NATIONALLICENCE)springer-10.1007/s00535-010-0361-y Comparison of steroid pulse therapy and conventional oral steroid therapy as initial treatment for autoimmune pancreatitis [Elektronische Daten] [Takashi Tomiyama, Kazushige Uchida, Mitsunobu Matsushita, Tsukasa Ikeura, Toshiro Fukui, Makoto Takaoka, Akiyoshi Nishio, Kazuichi Okazaki] Background: The efficacy of oral steroid therapy for autoimmune pancreatitis (AIP) is well known, and oral prednisolone treatment is most usually commenced at 30-40mg/day, but there have been few reports about comparative studies of oral steroid therapy and steroid pulse therapy as the initial treatment for AIP. We studied the clinical course and image findings to estimate the utility of steroid pulse therapy for AIP, comparing it with oral steroid therapy. Methods: Laboratory and image findings were assessed retrospectively in 11 patients who received steroid pulse therapy, and the findings were compared to those in 10 patients who received conventional oral steroid therapy. Results: Change in pancreatic size showed no significant difference between the therapies after 2weeks of treatment. Significant improvement of lower bile duct strictures after 2weeks of treatment and that of immunoglobulin values within 6months were shown with both therapies. However, steroid pulse therapy showed significant improvement of γ-guanosine triphosphate (GTP) in 2weeks and of alanine aminotransferase (ALT) in 2 and 8weeks, compared with oral steroid therapy. Moreover, there was one patient in whom the lower bile duct stricture was not improved by oral steroid therapy, but it did show improvement with steroid pulse therapy. Conclusions: Initial steroid pulse therapy is a beneficial alternative to oral steroid therapy for the improvement of bile duct lesions. In future, the accumulation of a larger number of patients receiving steroid pulse therapy is needed, and prospective studies will be required. Springer, 2010 Autoimmune pancreatitis (AIP) nationallicence Steroid pulse therapy nationallicence Bile duct stricture nationallicence Diabetes mellitus nationallicence Pancreatic cancer nationallicence Tomiyama Takashi Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Uchida Kazushige Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Matsushita Mitsunobu Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Ikeura Tsukasa Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Fukui Toshiro Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Takaoka Makoto Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Nishio Akiyoshi Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Okazaki Kazuichi Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut Journal of Gastroenterology Springer Japan 46/5(2011-05-01), 696-704 0944-1174 46:5<696 2011 46 535 https://doi.org/10.1007/s00535-010-0361-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-010-0361-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tomiyama Takashi Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Uchida Kazushige Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Matsushita Mitsunobu Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Ikeura Tsukasa Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Fukui Toshiro Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Takaoka Makoto Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Nishio Akiyoshi Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Okazaki Kazuichi Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, 570-8507, Moriguchi, Osaka, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/5(2011-05-01), 696-704 0944-1174 46:5<696 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer