pancreatic enzymes
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Author(s):  
M. V. Malykh ◽  
E. A. Dubtsova ◽  
L. V. Vinokurova ◽  
M. A. Kiryukova ◽  
D. S. Bordin

Changes in the exocrine function of the pancreas often develops after proximal and distal resections. Exocrine pancreatic insufficiency (EPI) is characterized by a reduced secretion of pancreatic enzymes, because of which the digestion and absorption of nutrients is impaired. Clinical manifestations of EPI and, as a consequence, changes in nutritional status significantly affect the quality of life of patients.


2021 ◽  
Vol 9 ◽  
Author(s):  
Sujin Choi ◽  
Hae Jeong Lee ◽  
An Na Seo ◽  
Han Ik Bae ◽  
Hyung Jun Kwon ◽  
...  

Introduction: Autoimmune pancreatitis (AIP) is a rare extraintestinal manifestation of inflammatory bowel disease (IBD) which is typically responsive to corticosteroid treatment.Case Presentation: We report a case of a 17-year-old male diagnosed with ulcerative colitis who subsequently developed acute pancreatitis. Blood tests demonstrated elevated pancreatic enzyme levels of amylase (1319 U/L) and lipase (809 U/L). Abdominal computed tomography revealed peripancreatic fat stranding and the presence of a perisplenic pseudocyst. Azathioprine and mesalazine were stopped as possible causes of drug-induced pancreatitis. However, pancreatic enzymes remained elevated and corticosteroid treatment was started. Despite corticosteroid therapy, amylase and lipase levels continued to increase. Infliximab was started due to a flare in gastrointestinal symptoms of ulcerative colitis. Follow-up abdominal ultrasonography revealed a pancreatic tail mass. Tumor markers, including CA 19-9, were elevated and atypical cells were seen on histological examination of an endoscopic ultrasonography-guided fine needle aspiration biopsy. Surgical pancreaticosplenectomy was performed for suspected pancreatic neoplasm. Surprisingly, histology revealed chronic pancreatitis with storiform fibrosis and infiltration of IgG4-positive cells, compatible with AIP type 1. Thereafter, pancreatic enzymes gradually decreased to normal levels and the patient has been in remission for 9 months on infliximab monotherapy.Conclusion: Pediatric gastroenterologists should keep in mind that AIP may develop during the natural course of pediatric IBD. Moreover, the development of pancreatic fibrosis may be non-responsive to corticosteroid treatment and mimic pancreatic neoplasia.


2021 ◽  
pp. 004947552110418
Author(s):  
Omkolsoum M Alhaddad ◽  
Maha M Elsabaawy ◽  
Eman A Rewisha ◽  
Omar A Shaarawy ◽  
Hanaa M Badran ◽  
...  

Acute fatty liver of pregnancy (AFLP) and acute pancreatitis are peculiar complications of pregnancy. When acute pancreatitis occurs co-incidentally with acute fatty liver of pregnancy, mortality is high. Here, we report a case of a 22-year-old lady in her 36th week of gestation, who presented with pre-eclampsia, acute fatty liver of pregnancy and acute pancreatitis. She fulfilled six Swansea criteria for diagnosis of AFLP, and the diagnosis of acute pancreatitis was based on clinical suspicion, elevated pancreatic enzymes and the sonographic appearance of a swollen pancreatic head.


2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Lotte Blonk ◽  
N J Wierdsma ◽  
E P Jansma ◽  
G Kazemier ◽  
D L Peet ◽  
...  

Abstract   Complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are often attributed to an impaired exocrine pancreatic function. This review systematically summarizes all literature reporting on the presence of exocrine pancreatic insufficiency (EPI) after esophagectomy and the effect of treatment with pancreatic enzymes on gastrointestinal complaints, body weight, and quality of life. Methods Databases of PubMed, Embase, and Wiley/Cochrane Library were searched systematically until July 2020. Studies reporting on EPI and pancreatic enzyme replacement therapy after esophagectomy were included. Results Four studies, including 158 patients, were selected. Exocrine pancreatic function was investigated in three studies, measured by fecal elastase-1 and 72-hour fecal fat excretion. Fecal elastase-1 levels <200 μg/g were reported in 16% of patients at 4 months, 18% at 6 months, and 31% at 18-24 months postoperatively. A decreased fecal fat absorption was noticed in 57% 1 month postoperatively. Treatment with pancreatic enzymes was reported in two studies. In patients with fecal elastase-1 levels <200 μg/g, 90% of patients reported improvement in symptoms and 70% reported improvement in weight. In patients with complaints of steatorrhea, 87% noticed settlement of symptoms. Conclusion Based on current literature, complaints of maldigestion, malabsorption, and unintended weight loss after esophagectomy are common and can be related to an impaired exocrine pancreatic function. High-quality studies evaluating the presence of EPI and the effect of treatment with pancreatic enzymes after esophagectomy are needed to verify this conclusion.


Author(s):  
Ifeoma Priscilla Ezeugwunne ◽  
◽  

Type 2 diabetes mellitus is the most common type of diabetes, having high blood glucose, reduced insulin secretion and / or inadequate glucagon secretion. The study is to assess the activities of pancreatic enzymes and anthropometric indices. 81 participants comprised 38 diabetic and 43 control were randomly recruited. Informed, oral and written consent was obtained from the participants. Ethical approval was obtained.6mls of fasting blood samples were collected. Plasma glucose; amylase and lipase activities were analyzed using standard laboratory methods. Body mass index (BMI) of participant was determined from height and weight. The results showed significantly increased plasma glucose level in the diabetic participants than in control at p=0.000 and in male diabetics than in female diabetics at p=0.048 in each case. But the activities of lipase, amylase, the mean age and BMI level were the same in both diabetic and control groups at p>0.05 respectively. BMI level, lipase and amylase activities were the same in both genders (p>0.05). Stronger positive correlation exist between Weight Vs BMI (r=0.834; p=0.000), followed by Lipase Vs Amylase (r=0.767; p=0.000), least between Age Vs BMI (r=0.353; p=0.022) but weaker negative associations exist between Height Vs BMI (r=-0.490; p=0.001) and Weight Vs FBS (r=-0.325; p=0.036) in the diabetic subjects. The significant higher level of blood glucose; stronger positive correlation between Lipase and Amylase; Weight and BMI may likely revealed pancreatic exocrine function abnormality in diabetes mellitus type 2.


2021 ◽  
Vol 8 ◽  
Author(s):  
Peili Ding ◽  
Bin Song ◽  
Xuelin Liu ◽  
Xing Fang ◽  
Hongliu Cai ◽  
...  

Background: Pancreatic enzyme elevation has been reported in patients with COVID-19 during the pandemic. However, with the shortage of medical resources and information, several challenges are faced in the examination and treatment of this condition in COVID-19 patients. There is little information on whether such condition is caused by pancreatic injury, and if this is a warning sign of life threatening complications like multiple organ failure in patients. The objective of this study is to explore the relationship between elevated pancreatic enzymes and the underlying risk factors during the management of COVID-19 patients.Method: A total of 55 COVID-19 patients admitted to the intensive care unit (ICU) of Wuhan Jinyintan hospital from January 1 to March 30, 2020 were enrolled in this study. All participants underwent transabdominal ultrasound imaging to assess their pancreas.Results: Out of the 55 patients, three patients had pancreatitis, 29 (52.7%) with elevated pancreatic enzymes, and 23 (41.8%) without. The most common symptoms of patients with COVID-19 were fever and cough. There was no statistical difference in most baseline characteristics except myalgia on admission. Compared with those having normal enzyme levels, patients with elevated pancreatic enzymes had higher rates of mortality (79.3 vs. 52.2%; P = 0.038), and lower rates of discharge (20.7 vs. 47.8%; P = 0.038). Patients with elevated enzymes had higher incidence of mechanical ventilation (P = 0.004) and kidney injury (P = 0.042) than patients without elevated pancreatic enzymes. The results of multivariable logistic analysis showed that the odds ratio were 10.202 (P = 0.002) for mechanical ventilation and 7.673 (P = 0.014) for kidney injury with the elevated enzymes vs. the normal conditions.Conclusions: The findings show that the incidences of pancreatic enzymes elevation are not low in critical COVID-19 patients and only a few of them progressed to acute pancreatitis (AP). Increased pancreatic enzymes levels is associated with poor prognosis in COVID-19 patients. In addition, the kidney injury and oxygenation degradation are associated with the pancreatic enzymes elevation in COVID-19 patients.


Pancreatology ◽  
2021 ◽  
Vol 21 ◽  
pp. S42-S43
Author(s):  
S. Leal-Lopez ◽  
L. Estevez-Perez ◽  
R. Gallego-Gomez ◽  
T. Garcia-Caballero ◽  
J. Perez-Camiña ◽  
...  
Keyword(s):  

2021 ◽  
Vol 17 (2) ◽  
pp. 164-167
Author(s):  
Anna Fedorczak ◽  
◽  
Dorota Szałowska-Woźniak ◽  
Krzysztof Zeman ◽  
◽  
...  

IgA vasculitis, also known as the Henoch–Schönlein purpura, is the most common systemic vasculitis in children. Inflammation most often involves small blood vessels of the skin, joints, kidneys and the gastrointestinal tract, but other organs may also be involved. Acute pancreatitis is a rare clinical manifestation of IgA vasculitis. We present a case of a 12-year-old girl with cutaneous and abdominal symptoms, who was diagnosed with acute pancreatitis during IgA vasculitis. In patients with IgA vasculitis who report abdominal pain acute pancreatitis should be taken into account and pancreatic enzymes measurement should be considered.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 473
Author(s):  
Piotr Jakimiec ◽  
Katarzyna Zdanowicz ◽  
Kamila Kwiatek-Sredzinska ◽  
Aleksandra Filimoniuk ◽  
Dariusz Lebensztejn ◽  
...  

Background and Objectives: Inflammatory bowel disease (IBD) is a chronic condition and mainly affects the intestines, however, the involvement of the other organs of the gastrointestinal tract (upper part, pancreas, and liver) have been observed. The coexistence of IBD with pancreatic pathology is rare, however, it has been diagnosed more frequently during recent years in the pediatric population. This article reviews the current literature on the most common pancreatic diseases associated with IBD in the pediatric population and their relationship with IBD activity and treatment. Materials and Methods: We performed a systematic review of data from published studies on pancreatic disorders, also reported as extraintestinal manifestations (EIMs), among children with IBD. We searched PubMed and Web of Science to identify eligible studies published prior to 25 April 2020. Results: Forty-four papers were chosen for analysis after a detailed inspection, which aimed to keep only the research studies (case control studies and cohort studies) or case reports on children and only those which were written in English. The manifestations of IBD-associated pancreatic disorders range from asymptomatic increase in pancreatic enzymes activity to severe disease such as acute pancreatitis. Acute pancreatitis (AP) induced by drugs, mainly thiopurine, seems to be the most- often-reported pancreatic disease associated with IBD in children. AP associated with other than drug etiologies, and chronic pancreatitis (CP), are rarely observed in the course of pediatric IBD. The pancreatic involvement can be strictly related to the activity of IBD and can also precede the diagnosis of IBD in some pediatric patients. The course of AP is mild in most cases and may occasionally lead to the development of CP, mainly in cases with a genetic predisposition. Conclusions: The involvement of the pancreas in the course of IBD may be considered as an EIM or a separate co-morbid disease, but it can also be a side effect of IBD therapy, therefore a differential diagnosis should always be performed. As the number of IBD incidences with concomitant pancreatic diseases is constantly increasing in the pediatric population, it is important to include pancreatic enzymes level measurement in the workup of IBD.


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