Document Detail

Comparison of steroid pulse therapy and conventional oral steroid therapy as initial treatment for autoimmune pancreatitis.
MedLine Citation:
PMID:  21188426     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The efficacy of oral steroid therapy for autoimmune pancreatitis (AIP) is well known, and oral prednisolone treatment is most usually commenced at 30-40 mg/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 2 weeks of treatment. Significant improvement of lower bile duct strictures after 2 weeks of treatment and that of immunoglobulin values within 6 months were shown with both therapies. However, steroid pulse therapy showed significant improvement of γ-guanosine triphosphate (GTP) in 2 weeks and of alanine aminotransferase (ALT) in 2 and 8 weeks, 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.
Takashi Tomiyama; Kazushige Uchida; Mitsunobu Matsushita; Tsukasa Ikeura; Toshiro Fukui; Makoto Takaoka; Akiyoshi Nishio; Kazuichi Okazaki
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-12-25
Journal Detail:
Title:  Journal of gastroenterology     Volume:  46     ISSN:  1435-5922     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-12     Completed Date:  2011-09-13     Revised Date:  2012-03-09    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  696-704     Citation Subset:  IM    
Division of Gastroenterology and Hepatology, the Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono, Moriguchi, Osaka 570-8507, Japan.
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MeSH Terms
Administration, Oral
Aged, 80 and over
Autoimmune Diseases / drug therapy*,  physiopathology
Bile Ducts / pathology
Constriction, Pathologic / drug therapy,  etiology
Follow-Up Studies
Glucocorticoids / administration & dosage,  therapeutic use*
Methylprednisolone / administration & dosage,  therapeutic use
Middle Aged
Pancreatitis / drug therapy*,  immunology,  physiopathology
Prednisolone / administration & dosage,  therapeutic use
Pulse Therapy, Drug
Retrospective Studies
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Glucocorticoids; 50-24-8/Prednisolone; 83-43-2/Methylprednisolone
Comment In:
J Gastroenterol. 2012 Jan;47(1):92-3; author reply 94-5   [PMID:  21932094 ]

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