A Case of Autoimmune Chronic Pancreatitis that was Rapidly Aggravated Despite Oral Steroid Maintenance Therapy / 대한소화기내시경학회지

In a case of autoimmune chronic pancreatitis that relapsed despite maintenance therapy with low-dose steroid, high- dose steroid can induce remission of the disease, and maintenance therapy of steroid is usually recommended in that case. A 57-year-old man developed epigastric pain and jaundice. The patient was diagnosed with autoimmune chronic pancreatitis. The abnormalities in the clinical, laboratory and radiologic findings improved after oral steroid therapy. After two relapsed episodes, maintenance therapy of steroid with 5 mg prednisolone/day was administrated. In the studies for follow up, the level of serum IgG was increased and abdominal computed tomography showed calcification and pseudocyst in the pancreatic tail. To our knowledge, this is a rare case of autoimmune chronic pancreatitis aggravated rapidly despite oral steroid maintenance therapy.

Relapse Rates of Ulcerative Colitis in Remission and Factors Related to Relapse / 대한소화기학회지

BACKGROUND/AIMS: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with heterogeneous clinical features. Data on the disease course and prognosis of UC patients who have been regularly treated are lacking. We aimed to investigate relapse rates of UC in remission and factors related to relapse. METHODS: We retrospectively analyzed clinical courses of 84 patients (43 males, median age 43 years, ranged 20-73 years) diagnosed as UC at Ajou University Hospital between January 1997 and December 2005 based on clinical, endoscopic and pathologic findings, and who were regularly followed for at least one year after the remission. RESULTS: Study subjects consisted of 32 proctitis (38%), 21 left-sided colitis (25%), and 31 subtotal or total colitis (37%). Of 84 patients, relapse was observed in 52 patients (62%) during the follow-up period (ranged 1-9 years). The relapse rate was 24%, 41%, 51%, 65%, 71%, and 79% at 1 year, 2 years, 3 years, 4 years, 5 years and 6 years, respectively. Among sex, age, hemoglobin, ESR, and the extent of disease on admission, decrease of hemoglobin level was the only independent factor related to relapse (odds ratio=2.67, 95% CI (1.32-5.42), p<0.01). CONCLUSIONS: In Korea, relapse of UC in remission is not rare. Decrease of hemoglobin level is an independent risk factor related to its relapse, while the extent of disease is not.