TRATTAMENTO DELLA PANCREATITE AUTOIMMUNE CON AZATIOPRINA: RISULTATI SU UNA CASISTICA PERSONALE CON VALUTAZIONE DEI POSSIBILI EFFETTI COLLATERALI E DELL’ASSOCIAZIONE CON MALATTIE INFIAMMATORIE CRONICHE INTESTINALI.

Autoimmune pancreatitis (AIP) is a disease with difficult diagnostical and therapeuthical approach. Indeed, steroid theraphy is effective in the short term treatment, but ii do not prevent the disease relapse. A part of AIP patients need therefore a long term immunosuppressive therapy. Clinical, biochemical and instrumental characteristic of patients at risk for relapse seems to be the presence of jaundice at clinical onset, increase of serum levels of IgG4, and the extrapancreatic involvement, that seems therefore to be prognostic factor for relapse. In these patients, immunosuppressant is indicated. Azathioprin has been suggested the treatment of choice on the basis of the results of our study. Furthermore, our systematic review and our results on AIP patients treated whit this drug seems not to increase the risk of pancreatitis during the treatment of azathioprin. The clinical profile of AIP patients suffering from ulcerative colitis is not different from the other AIP patients. Since ulcerative colitis may be treated with immunosuppressant, its presence do not exclude a possible treatment with azathioprin. Prospective multicenter studies are suggested to confirm our conclusions.