scholarly journals Multiomic definition of generalizable endotypes in human acute pancreatitis

2019 ◽  
Author(s):  
Lucile P. A. Neyton ◽  
Xiaozhong Zheng ◽  
Christos Skouras ◽  
Andrea Doeschl-Wilson ◽  
Michael U. Gutmann ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Distress Syndrome ◽  
Sudden Onset ◽  
Multiple Organ ◽  
Innate Immune ◽  
Metabolomic Data ◽  
Human Acute Pancreatitis ◽  
Definition Of ◽  
Clinical Measures ◽  
Internal And External Validity

AbstractAcute pancreatitis (AP) is sudden onset pancreas inflammation that causes multiple organ dysfunction syndrome (MODS) and death in certain individuals who develop AP yet minimal systemic inflammation in others. Here, we show that this observed diversity in systemic response and outcome is accompagnied by diversity in molecular subtypes that can be identified using computational analysis of clinical and multiomic data. We integrated co-incident whole blood transcriptomic, plasma proteomic, and serum metabolomic data at serial time points from a cohort of patients presenting with AP and systematically evaluated four different metrics for patient similarity, using unbiased mathematical, biological and clinical measures of internal and external validity. Our results identify four distinct and stable AP endotypes that are characterized by pathway and biomarker combination stereotypes into hypermetabolic, hepatopancreaticobiliary, catabolic and innate immune endotypes. The catabolic endotype in AP strikingly recapitulates a disease endotype previously reported in acute respiratory distress syndrome, a recognized complication of AP. Our findings demonstrate that clinically-relevant and generalizable endotypes exist in AP.

VALUE OF COMBINATION OF HAP SCORE AND BISAP SCORE IN PREDICTING SEVERITY IN PATIENTS OF ACUTE PANCREATITIS

2019 ◽  
pp. 96-100
Author(s):  
Thi Ngoc Suong Le ◽  
Pham Chi Tran ◽  
Van Huy Tran
Keyword(s):  
Acute Pancreatitis ◽  
Positive Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Prognostic Value ◽  
Acute Inflammation ◽  
Clinical Symptoms ◽  
Mortality Rates ◽  
Multiple Organ ◽  
Central Hospital

Acute pancreatitis (AP) is an acute inflammation of the pancreas, usually occurs suddenly with a variety of clinical symptoms, complications of multiple organ failure and high mortality rates. Objectives: To determine the value of combination of HAP score and BISAP score in predicting the severity of acute pancreatitis of the Atlanta 2012 Classification. Patients and Methods: 75 patients of acute pancreatitis hospitalized at Hue Central Hospital between March 2017 and July 2018; HAP and BISHAP score is calculated within the first 24 hours. The severity of AP was classified by the revised Atlanta criteria 2012. Results: When combining the HAP and BISAP scores in predicting the severity of acute pancreatitis, the area under the ROC curve was 0,923 with sensitivity value was 66.7%, specificity value was 97.1%; positive predictive value was 66.7%, negative predictive value was 97.1%. Conclusion: The combination of HAP and BISAP scores increased the sensitivity, predictive value, and prognostic value in predicting the severity of acute pancreatitis of the revised Atlanta 2012 classification in compare to each single scores. Key words: HAPscore, BiSAP score, acute pancreatitis, predicting severity

scholarly journals A fatal toxic shock-like syndrome post COVID-19 infection in a child

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Houda Ajmi ◽  
Wissem Besghaier ◽  
Wafa Kallala ◽  
Abdelhalim Trabelsi ◽  
Saoussan Abroug
Keyword(s):  
Ejection Fraction ◽  
Pediatric Intensive Care ◽  
Fresh Frozen Plasma ◽  
Multiple Organ ◽  
Clinical Feature ◽  
Fresh Frozen ◽  
Life Threatening ◽  
High Doses ◽  
Definition Of ◽  
High Level

Abstract Background Children affected by Coronavirus disease 2019 (COVID-19) showed various manifestations. Some of them were severe cases presenting with multi-system inflammatory syndrome (MIS-C) causing multiple organ dysfunction. Case presentation We report the case of a 12-year-old girl with recent COVID-19 infection who presented with persistent fever, abdominal pain and other symptoms that meet the definition of MIS-C. She had lymphopenia and a high level of inflammatory markers. She was admitted to pediatric intensive care unit since she rapidly developed refractory catecholamine-resistant shock with multiple organ failure. Echocardiography showed a small pericardial effusion with a normal ejection fraction (Ejection Fraction = 60%) and no valvular or coronary lesions. The child showed no signs of improvement even after receiving intravenous immunoglobulin, fresh frozen plasma, high doses of Vasopressors and corticosteroid. His outcome was fatal. Conclusion Pediatric patients affected by the new COVID-19 related syndrome may show severe life-threatening conditions similar to Kawasaki disease shock syndrome. Hypotension in these patients results from heart failure and the decreased cardiac output. We report a new severe clinical feature of SARS-CoV-2 infection in children in whom hypotension was the result of refractory vasoplegia.

Multiple organ dysfunction associated with severe acute pancreatitis (SAP)

2001 ◽  
Vol 120 (5) ◽  
pp. A644-A645
Author(s):  
Kimmo I. Halonen ◽  
Ville Pettila ◽  
Ari K. Leppaniemi ◽  
Esko A. Kemppainen ◽  
Pauli A. Puolakkainen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Dysfunction ◽  
Severe Acute Pancreatitis ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction

scholarly journals Clinical and therapeutic correlations in patients with slight acute pancreatitis

2015 ◽  
Vol 28 (1) ◽  
pp. 24-27 ◽  
Author(s):  
Clewis Henri MUNHOZ-FILHO ◽  
Fernando BATIGÁLIA ◽  
Hamilton Luiz Xavier FUNES
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Vital Signs ◽  
Positive Association ◽  
Multiple Organ ◽  
Glutamic Oxaloacetic Transaminase ◽  
Serum Glutamic Oxaloacetic Transaminase ◽  
Early Return ◽  
Lower Spectrum ◽  
Mild Acute Pancreatitis

BACKGROUND: Acute pancreatitis is an inflammatory disease of the pancreas due to enzymatic autodigestion which can cause necrosis or multiple organ failure; its pathophysiology is not fully known yet. AIM: To evaluate the correlation between clinical and therapeutic data in patients with mild acute pancreatitis. METHODS: A retrospective study in 55 medical records of patients admitted with acute mild pancreatitis was realized to analyze the association between age, leukocytosis, serum glutamic-oxaloacetic transaminase and lactate dehydrogenase, glucose, antibiotics, time admission and Ranson´s scores. RESULTS: There was a positive association between less intensive care (strict hydration, analgesia and monitoring of vital signs), early antibiotic therapy (monotherapy), early return to diet after 48 hours and laboratory control of the serum amylase and lipase (high in the first week and decreasing after 10 days, without any prognostic value). CONCLUSIONS: Changes in the management of patients with mild acute pancreatitis, such as enteral nutrition, rational use of lower spectrum antibiotics and intensive care, have contributed significantly to the reduction of hospitalization time and mortality.

scholarly journals Clinical Pattern and Management of Acute Pancreatitis – Our Experience

2014 ◽  
Vol 31 (3) ◽  
pp. 122-127
Author(s):  
MM Hasan ◽  
SZ Laila ◽  
MH Mamun
Keyword(s):  
Acute Pancreatitis ◽  
Gall Stone ◽  
Multiple Organ ◽  
High Serum ◽  
Military Hospital ◽  
Average Hospital ◽  
Systemic Involvement ◽  
Standard Management ◽  
Management Protocol ◽  
Upper Abdomen

Background: Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas that may extend to local and distant extrapancreatic tissues. It is a life threatening disease that has many causes, few effective treatments, numerous serious complications, and an often unpredictable course. The objectives of this study are to develop our knowledge about presentation and diagnosis of acute pancreatitis, to assess the patient with acute pancreatitis accurately and to develop a standard management protocol. Methods: This observational study was carried out in Combined Military Hospital (CMH) Dhaka, CMH Momenshahi and CMH Ghatail during the period of June 2007 to December 2010. A total 25 patients of Acute Pancreatitis were studied retrospectively, evaluated and managed.Results: In this study 25 patients 19 (76%) were male (male : female = 3.17:1), age range 08 to 55 years, Mean age – 38.92 years. Maximum number of the patients fall into fourth and fifth decades. All patients presented with abdominal pain, specially in upper abdomen. Laboratory test revealed leucocytosis and high serum and urinary amylase, positive findings in Ultrasonogram and CT scan found in all patients. Gall stone was the leading cause 14 (56%). 20 (80%) patient developed some form of complications. 24 patients were treated conservatively. Average hospital stay was 15.52 days. Serious regional and systemic involvement in Acute Pancreatitis causes multiple organ or system failure. Conclusion: Early diagnosis and effective treatment can significantly reduce the morality and morbidity. DOI: http://dx.doi.org/10.3329/jbcps.v31i3.20977 J Bangladesh Coll Phys Surg 2013; 31: 122-127

scholarly journals Acute pancreatitis : a newly recognised potential complication of canine babesiosis

2000 ◽  
Vol 71 (4) ◽  
Author(s):  
A.J. Möhr ◽  
R.G. Lobetti ◽  
J.J. Van der Lugt
Keyword(s):  
Renal Failure ◽  
Acute Pancreatitis ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Haemolytic Anaemia ◽  
Distress Syndrome ◽  
Pathophysiological Mechanism ◽  
Canine Babesiosis ◽  
Immune Mediated

This retrospective study describes 4 cases of canine babesiosis with histologically confirmed acute pancreatitis. In addition, 16 dogs with babesiosis are reported with serum amylase (>3500 U/l ) and/or lipase (>650 U/l ) activity elevations of a magnitude that would support a diagnosis of probable acute pancreatitis, although extra-pancreatic sources of the enzymes could not be excluded in these cases. Median time of pancreatitis diagnosis was 2.5 days post-admission, with primarily young (median age 3 years), sexually intact dogs affected. The development of pancreatitis was unrelated to the degree of anaemia at time of admission. In addition to pancreatitis, 80 % of cases suffered from other babesial complications, namely icterus (13), acute respiratory distress syndrome (6), immune-mediated haemolytic anaemia (6), renal failure (3), haemoconcentration (2) and cerebral syndrome (2). Acute respiratory distress syndrome, renal failure and cerebral syndrome were associated with a poor prognosis, with 4 of the 5 dogs included in the overall 26 % mortality rate having at least 1 of these complications. Haemolytic anaemia with ischaemia-reperfusion injury to the pancreas is proposed as a possible primary pathophysiological mechanism in babesial pancreatitis. Hypotensive shock, immune-mediated haemolytic anaemia, haemoconcentration and possibly altered lipid metabolism in babesiosis may also be involved. The previously postulated pro-inflammatory cytokine milieu of complicated babesiosis may underlie the progression, if not the primary initiation, of pancreatic pathology. Acute pancreatitis may represent the previously reported 'gut' form of babesiosis.

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