Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. May 6, 2018; 9(2): 16-21
Published online May 6, 2018. doi: 10.4292/wjgpt.v9.i2.16
Hypothyroidism in patients with autoimmune pancreatitis
Ryoko Shimizuguchi, Terumi Kamisawa, Yuka Endo, Masataka Kikuyama, Sawako Kuruma, Kazuro Chiba, Taku Tabata, Satomi Koizumi
Ryoko Shimizuguchi, Terumi Kamisawa, Yuka Endo, Masataka Kikuyama, Sawako Kuruma, Kazuro Chiba, Taku Tabata, Satomi Koizumi, Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo 113-8677, Japan
Author contributions: All authors helped to perform the research; Shimizuguchi R and Kamisawa T wrote manuscript, collected and analyzed data; Endo Y, Kikuyama M, Kuruma S, Chiba K, Tabata T and Koizumi S collected data.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Tokyo Metropolitan Komagome Hospital.
Informed consent statement: This study is a retrospective our using information that had been obtained according to comprehensive agreement.
Conflict-of-interest statement: All authors declare no conflict-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Terumi Kamisawa, MD, PhD, Chief Doctor, Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Tokyo 113-8677, Japan. kamisawa@cick.jp
Telephone: +81-3-38232101 Fax: +81-3-38235433
Received: November 27, 2017
Peer-review started: November 28, 2017
First decision: January 2, 2018
Revised: January 19, 2018
Accepted: March 6, 2018
Article in press: March 7, 2018
Published online: May 6, 2018
Processing time: 133 Days and 21.7 Hours
ARTICLE HIGHLIGHTS
Research background

Autoimmune pancreatitis (AIP) is a pancreatic manifestation of IgG4-related disease (IgG4-RD) and is frequently associated with other IgG4-RDs. AIP has been reported to be complicated with various other IgG4-RDs such as sclerosing cholangitis, sialadenitis, dacryoadenitis, retroperitoneal fibrosis, interstitial lung disease, and tubulointerstitial nephritis.

Research motivation

It was reported for the first time that 26.8% of 41 AIP patients showed hypothyroidism in 2005. However, there are only a few reports regarding thyroid function in AIP patients.

Research objective

The objective of this study was to examine thyroid function and clinical features of hypothyroidism in AIP patients.

Research methods

We examined thyroid function in 77 patients with type 1 AIP (50 males, 27 females; median age 68 years, range 33-85) diagnosed according to the Japanese diagnostic criteria for AIP 2011. We compared clinical and serological findings between patients with and without various categories of hypothyroidism. The change in hypothyroidism after steroid therapy was also examined.

Research results

Eight patients (10%) had hypothyroidism of 6 patients had subclinical hypothyroidism with a normal serum free thyroxine (FT4) and high thyroid stimulating hormone (TSH) level, and 2 patients had central hypothyroidism with low serum free triiodothyronine (FT3), FT4 and TSH levels. A significant goiter of the thyroid was not observed in any patient. There were no significant differences in age; male to female ratio; serum concentrations of IgG and IgG4; presence of anti-thyroglobulin antibody, antinuclear antigen or rheumatoid factor; or presence of extrapancreatic lesions between the 6 patients with subclinical hypothyroidism and patients with euthyroidism. After steroid therapy, both subclinical and central hypothyroidism improved with improvement of the AIP.

Research conclusions

Hypothyroidism was observed in 8 (10%) of 77 AIP patients and was subclinical in 6 patients and central in 2 patients. Further studies are necessary to clarify whether this subclinical hypothyroidism is another manifestation of IgG4-RD.

Research perspectives

Further studies are necessary to clarify whether this hypothyroidism is another manifestation of IgG4-RD.