Table 1. Summary of previous studies.
|
Observational
studies |
||
|
Derk [11] |
Retrospective;
2947 hospitalizations due to SLE between 1982 and 2002 |
5
cases of pancreatitis (0.85%) |
|
Pascual-Ramos [7] |
Retrospective
case-control design - patients with SLE and pancreatitis between 1984 -2001 |
35
identified patients; In 26 acute pancreatitis was an isolated event,
recurrent in 9 patients |
|
Vergara-Fernandez
[19] |
Prospective;
11 years of follow-up - 73 SLE patients with abdominal pain |
21
patients had pancreatitis: 6 caused by gallstones, 5 by drugs, 4 associated
to SLE, 4 unknown, 2 alcohol |
|
Campos
[20] |
Retrospective;
263 patients with juvenile SLE |
11
patients with acute pancreatitis, 1 with recurrent episodes. Association of
pancreatitis with disease activity and hemophagocytic
syndrome |
|
Chang
[21] |
Retrospective
cohort of pancreatitis in patients under 18 years between1993-2008 |
7
patients with SLE, 4 died |
|
Makol [16] |
Prospective
cohort of 1811 SLE patients |
76
patients with pancreatitis, in which this was attributable to SLE in 63.
Association with hypertriglyceridemia, psychosis, pleurisy, anemia. No association with antiphospholipid
syndrome |
|
Xu [22] |
Retrospective.
Cohort of 177 patients with SLE |
3
patients with pancreatitis |
|
Dhir [10] |
Retrospective;
550 patients with SLE |
10
patients with pancreatitis, the majority in the beginning of disease (less
than 1.5ys of SLE) |
|
Proca [23] |
Retrospective Cohort
of patients submitted to pancreatic resection due to chronic pancreatitis |
One
of 44 patients had diagnosis of SLE |
|
Wang
[12] |
Retrospective.
2976 SLE patients. Between 1991-2005 |
48
episodes of pancreatitis in 40 patients (13 children and 27 adults). Children
more frequent than adults; predominantly females; 2 patients as initial
manifestation of SLE; adults with bigger survival than children |
|
Tu [24] |
Retrospective,
SLE patients with abdominal pain |
5
pancreatitis cases in 23 children; 14 pancreatitis cases in 88 adults |
|
Dhaou [25] |
Retrospective,
monocentric |
Pancreatitis
present in 6 of 110 patients. In 4, it was the initial manifestation of SLE |
|
Goel [6] |
Retrospective.
Cohort of 551 SLE patients |
11
patients with acute pancreatitis, all in the first 12 months of disease |
|
Yang
[8] |
Retrospective;
Follow-up of 4053 SLE patients between 2000-2012 |
27
patients had acute pancreatitis. Pancreatitis was associated to high SLEDAI,
multi-organ involvement, high mortality. 12 patients got recovery with GC |
|
Yuan
[2] |
Retrospective,
cohort of 3823 SLE patients between 2002-11 |
23
patients with acute pancreatitis (same cohort of Yang 2012, patients not
included in counting) |
|
Case reports and case
series |
||
|
Wolman
[26] |
1
patient (25ys, female) |
Pancreatitis
as early manifestation of SLE |
|
Yeh [27] |
4
patients |
All
patients had anticardiolipin antibodies. At
autopsy, all had thrombi in the pancreas |
|
Hortas [28] |
2
patients, one of them with diagnosed systemic sclerosis |
Female,
61ys - 3 episodes of pancreatitis, with overture of clinical SLE just before
the third |
|
Lam
[29] |
1
patient (65ys, female) |
Pancreatitis
after 1 year of SLE, with death |
|
Marum [30] |
1
patient |
Pancreatitis
as early manifestation of SLE |
|
Cutlan [31] |
1
patient (21ys, female) |
Pancreatitis
and panniculitis as initial manifestations of SLE |
|
Ramanan [32] |
1
patient (14ys, female) |
Positive
anticardiolipin antibodies |
|
Duncan
[33] |
1
patient |
Initial
manifestation of SLE |
|
Fan
[34] |
1
patient (12ys, female) |
Pancreatitis
as early manifestation of SLE, good response to GC |
|
Fantini [35] |
1
patient (23ys, female) |
Pancreatitis
and hemolytic anemia
during SLE flare. Invasive aspergillosis as a
complication. Death after 17 days. |
|
Penalva [36] |
1
patient (14ys, female) |
Calcifying
chronic pancreatitis |
|
Singh
[37] |
1
patient (24ys, female) |
SLE
and TTP onset after an acute pancreatitis episode. Treatment with GC and plasmapheresis, with full recovery |
|
Swol-Ben [38] |
1
patient (59ys, female) |
Pancreatic
pseudotumor with pancreatic fibrosis; antiphospholipid syndrome. Treatment with cyclosporine,
immunoglobulin, GC |
|
Izzedine [39] |
1
patient (59ys, female) |
One
episode of acute pancreatitis preceding relapse of lupus nephritis. She
presented pancreatic calcifications and pseudocysts |
|
Wang
[3] |
1
patient (46ys, female) |
Pancreatitis
as initial manifestation of SLE; Successful treatment with somatostatin |
|
Nesher [5] |
3
patients |
High
mortality |
|
Agoumi [40] |
1
patient |
Pancreatitis
as initial manifestation of SLE |
|
Ergas [41] |
1
patient (male) |
Relapsing
pancreatitis responding to GC treatment |
|
Kobayashi
[42] |
1
patient (37ys, female) |
Pancreatitis
and elevation of IgG4. Treatment with GC |
|
Carducci
[43] |
2
patients (24 and 34ys, females) |
Pancreatitis
as initial manifestation of SLE. Treatment with GC and somatostatin |
|
Gutierrez
[44] |
1
patient (26ys, female) |
Calcifying
chronic pancreatitis in 2 years of SLE onset |
|
Tominaga [45] |
1
patient (12ys, female) |
Pancreatitis
as initial manifestation of SLE. Treatment with plasmapheresis,
methylprednisolone and cyclophosphamide, with full recovery |
|
Myung [46] |
1
patient (33ys, female) |
Pancreatitis,
pseudocyst and central nervous system vasculitis; Improved with GC, but had just after infeccion of pseudocyst,
improved with local surgery |
|
Rose
[47] |
1
patient (14ys, female) |
Pancreatitis
as initial manifestation of SLE. Treatment with methylprednisolone and oral
GC |
|
Vyas
[48] |
1
patient; Previous diagnosis of SLE and secondary antiphospholipd
syndrome |
Relapsing
ischemic pancreatitis, resistant to CS and anticoagulation. Better results
with plasmapheresis, GC, cyclophosphamide and
anticoagulation |
|
Cairoli [49] |
1
patient (39ys, female) |
Acute
pancreatitis during a severe lupus flare; pseudocysts;
death despite GC use |
|
Campos
[50] |
2
patients |
Female,
27ys: pancreatitis one year after diagnosis of SLE. Good response to GC.
Female, 20ys: just after diagnosis of SLE, death by spontaneous rupture of
pancreatic pseudocyst |
|
Geraldino [51] |
1
patient (29ys, female) |
Pancreatitis
as early manifestation of SLE (2 months), accompanied of parotiditis.
Resolution with GC in high dosage |
|
Ko [52] |
1
patient |
In
the post-partum period, manifestations of SLE started, followed by acute
pancreatitis |
|
Al-Musawi [17] |
1
patient with recurrent attacks of acute pancreatitis |
Patient
was treated with rituximab (antiCD20 monoclonal antibody), maintaining
remission for 2 years |
|
Hoorn
[53] |
1
patient (25ys, female) |
Pancreatitis
with pseudocyst. Treatment with GC, azathioprine,
immunoglobulin, with recovery |
|
Malavya [54] |
1
patient (55ys, female), history of 6 ys of SLE |
Treatment
with cyclophosphamide and methylprednisolone |
|
Linwattana [14] |
3
patients (11ys, 7ys and 18ys, female) |
Successful
treatment with GC |
|
Domingues-Pinilla [55] |
1
patient (12ys, female) |
Pancreatitis
as early manifestation of SLE. Treatment with methylprednisolone and hydroxychloroquine |
|
Nguyen
[56] |
1
patient (38ys, female) |
Antiphospholipid syndrome, initial manifestation.
Thrombotic microangyopathy in the pancreas and
kidneys |
|
Studies without full
text available or text in languages other than English, French, Portuguese,
Spanish or Italian |
||
|
György [57] - 1 patient (52ys,
female)- histology: nucleophagocytosis, leukophagocytosis, erytrhophagocytosis
in the pancreas Hamed [58] - 3 patients with
SLE - 2 died of hemorrhagic pancreatitis and 1 had pseudocysts Reynolds
[59] - Retrospective
- 20 patients out of 63 SLE patients had pancreatitis, 4 attributable to SLE,
with recovering with GC Ossi [60] - 1 patient - SLE
with pancreatitis during flare, recovery with plasmapheresis
and GC Simons-Ling
[61] - 1 patient
(12ys, female) - pancreatitis,panniculitis and calcynosis Zanen [62] - 1 patient (33ys,
female) - pancreatitis during severe flare. Recovery with plasmapheresis
and GC Brujin [63] - 1 patient (16ys,
female) - pancreatitis without histologic findings of autoimmune activation
in pancreas Giordano
[64] - Pancreatitis
as initial manifestation of SLE, treatment with methylprednisolone Rupprecht [65] - 1 patient (17ys,
female) - chronic pancreatits since her 11 years,
then onset of SLE. Use of azathioprine, GC, plasmapheresis
and cyclophosphamide Eaker [66]- Pancreatitis as
initial manifestation of SLE Pereira
[67] - Pancreatitis
during flare of SLE, recovery with GC Levy
[68] - cohort of
pancreatic patients with unfavorable outcomes of
SLE- 1 patient with pancreatitis Serrano-López [69] - autopsy of a
patient with SLE - pancreatitis with vascular damage and intimal
proliferation Garcia-Consuegra [70] - 1 patient (15ys,
female) - acute pancreatitis with psudocyst
formation Wang
[71] - 1 patient
(39ys, female) - elevated anticardiolipin. Postmortem examen with
generalized thrombi formation. In the pancreas, chronic inflammation with
thrombi in pancreatic arteries, without vasculitic
changes Borum [72] - 2 patients with
chronic pancreatitis Braun
[73] - 1 patient
(15ys, female) - mixed disease of the connective tissue - widespread vasculopathy with intima proliferation and minimal
fibrosis Huang
[74] - 1 patient
(13ys, female) - Pancreatitis as early manifestation of SLE. Treatment with
GC Huong [75] - 5 patients, 3
died Kolk [76] - 1 patient (16ys,
female) - autoimmune vasculitis Leong
[77] - 1 patient -
good response to GC high doses Saab
[78] - Retrospective
cohort - 8 patients with lupus pancreatitis in 10 years, with good response
to GC Tahara [79] - 1 patient (22ys,
female) - Pancreatitis as early manifestation of SLE. Good response to GC Hani
[80] - 2 patients,
both died Saito
[82] - 1 patient -
Concomitant onset of SLE and pancreatitis. Treatment with GC Abdallah [82] - 1 patient, SLE
for 7 years - pancreatitis and hemofagocytic
syndrome. Ozenc [83] - 1 patient; pseudocyst Perrin
[84] - 1 patient
(13ys, female) - Pancreatitis as initial manifestation of SLE. Treatment with
mycophenolate mophetil
and GC Suzuki
[85] - 1 patient
with overlap of systemic sclerosis and SLE. Treatment with GC and plasmapheresis Duval [86] - 1patient, 27ys,
female. Pancreatitis as early manifestation of SLE Wang [87] - Retrospective,
28 autoimmune disease related pancreatitis - 20 SLE, 6 Sjögrens’s
syndrome Soyibo [88] - 1 patient (50ys,
female) Ghamarchehreh [18] - 1 patient (24ys,
female), 2 episodes in the onset of SLE. Use of GC and rituximabe,
evolution to death Koga [89] - 1 patient (55ys,
female) - pseudocysts with rupture Medeiros [90] - retrospective;
136 patients, 3 with clinical pancreatitis, 7 with subclinical pancreatitis Elgatni [91] - Pancreatitis and
hemophagocytosis as initial manifestation of SLE |
||
GC
= glucocorticoids