Pancreatic Vasculitis in Collagen Diseases

Concerning pancreatic vasculitis in collagen diseases, necrotizing arteritis has been reported in the cases with polyarteritis nodosa (PAN) and SLE. Kojima reported that in PAN the incidence of necrotizing arteritis was 60% (12/20 autopsy cases) [1]. In SLE, the incidence of such arteritis has been reported as 7.4% (2/27 autopsy cases) and 6.2% (1/16 autopsy cases) [2-3]. Although a few reports of pancreatic vasculitis in collagen diseases have been published, systematic examination of the pancreatic vasculitis in collagen diseases was not performed. In 1987, Yoshimine, a member of my research group for vasculitis, examined vasculitis in the histological sections from pancreatic head, body and tail in 51 autopsy cases with PAN, SLE, rheumatoid arteritis (RA) or SSc [4]. The incidence of necrotizing arteritis in each disease was 71% in PAN, 53% in SLE, 50% in RA and 17% in SSc. The arteritis presented necro-tizing arteritis of the PAN type (fig. 1) and was located in the small and medium-sized arteries. The incidence of arteritis in the pancreatic head was larger than that in the pancreatic body and tail. The arteritis produced hemonecrosis in the pancreatic parenchyma surrounding the severely injured arteries (fig. 1), but not massive necrosis in the parenchyma of the pancreas.

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