Chronic pancreatitis (CP) is considered to be a rare cause of diabetes mellitus. However, in both the developed and developing world, there is an increasing number of patients suffering from pancreati
In 394 consecutive autopsies, tissue from the body of the pancreas showed chronic inflammation in 52 cases (13%); 32 were mild, II moderate and 9 severe. Only two of these cases had the clinical diagnosis chronic pancreatitis. The incidence of inspissated plugs of protein in the ducts, dilated ducts and acinar ectasia was significantly higher when chronic inflammation was present. There was a significant higher incidence of chronic inflammation in the pancreas in patients with diabetes mellitus....
Histopathological changes of biopsied pancreata were examined in three diabetic patients with autoimmune chronic pancreatitis (ACP). We found intra- and periinsular mononuclear cell (MNC)-mainly CD8+ T cell-infiltration as well as MNC infiltration around the ductal cells. Islet beta cell volume decreased significantly. Some ductal cells expressed insulin and insulin promoter factor-1 concomitantly in the affected pancreas. These findings provide new insight toward understanding the pathological ...
Objective The prevalence and main determinants of exocrine pancreatic insufficiency were investigated in a large population-based sample of older adults by measuring pancreatic elastase-1 in stool. Material and methods The study comprised 914 participants aged 50 to 75 years recruited by their general practitioner during a general health examination. All participants and their physicians were asked to fill out a standardized questionnaire which contained information on socio-demographic and life...
these proportions had increased to 26% and 22%, respectively, with 55% of women and 66% of men being overweight (BMI > 25 kg/m 2 ; Health Survey for England, 2001), reflecting a worldwide trend which is most marked in, but not restricted to, the developed world. Most of us in affluent countries live in a privileged land of plenty where high calorie foods are easily available and in which we have a limited need for exercise. The rising prevalence of obesity in children is of particular concern (C...
#1Stefan Maartense(LUMC: Leiden University Medical Center)H-Index: 4
#2Michael Ledeboer(LUMC: Leiden University Medical Center)H-Index: 1
Last. Ad A.M. Masclee(LUMC: Leiden University Medical Center)H-Index: 74
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Abstract Background Resection and drainage procedures are performed for chronic pancreatitis. After resection, pancreatic function deteriorates; however, little is known about the effect of drainage procedures. Methods Pancreatic function was evaluated prospectively before and after surgery in 27 patients with duodenum-preserving resection of the head of the pancreas (DPRHP), and in 12 patients with pancreatico-jejunostomy (P-JS); 18 patients with chronic pancreatitis served as controls. Results...
#1Stefan Maartense(LUMC: Leiden University Medical Center)H-Index: 4
#2M. Ledeboer(LUMC: Leiden University Medical Center)H-Index: 1
Last. Ad A.M. Masclee(LUMC: Leiden University Medical Center)H-Index: 74
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Abstract Background. In our department, we routinely use a combined exocrine–endocrine function test to evaluate the pancreatic function in chronic pancreatitis i.e. urinary para amino benzoic acid (PABA) recovery and pancreatic polypeptide secretion in response to a meal and glucose tolerance test. Aim. To study the relationship between changes in morphology and exocrine/endocrine function in patients with chronic pancreatitis. Patients and methods. In 103 patients with chronic pancreatitis see...
OBJECTIVES: Chronic pancreatitis may lead to considerable reduction in health-related quality of life, but factors associated with a poor perceived health status have not been investigated. METHODS: We recruited 265 patients with chronic pancreatitis from a tertiary care gastroenterology clinic. Health-related quality of life was assessed using the Short Form-36 Health Survey. Data were compared with age- and gender-adjusted values from the German general population (6964 adults). Factors associ...
Tropical chronic pancreatitis (TCP) is a juvenile form of chronic calcific non-alcoholic pancreatitis, seen almost exclusively in the developing countries of the tropical world. The classical triad of TCP consists of abdominal pain, steatorrhoea, and diabetes. When diabetes is present, the condition is called fibrocalculous pancreatic diabetes (FCPD) which is thus a later stage of TCP. Some of the distinctive features of TCP are younger age at onset, presence of large intraductal calculi, more a...
The etiology of pain in chronic pancreatitis may be ductal hypertension, increased parenchymal pressure, or neural damage. It is difficult to assess the severity of pain in this patient population, a problem made more challenging by the frequency of narcotic dependency. Therapeutic interventions developed to relieve the pain of chronic pancreatitis include denervation of the pancreas, decompression of the main duct of the pancreas, resection of part or all of the diseased pancreas, and reduction...
GOALS: To evaluate the quality of life (QoL) of patients with chronic pancreatitis before and after pancreatic enzyme replacement therapy in a prospective, multicentre, follow-up study.
Introduction Insulin-like growth factor 1 (IGF-1) has been connected with development of pancreatic ductal adenocarcinoma (PDAC). Aim To evaluate the serum concentration levels of IGF-1 and insulin-like growth factor binding protein 2 (IGFBP-2) in patients with chronic pancreatitis (CP) and PDAC. Their values in diabetes mellitus (DM) were also assessed. Material and methods The study included 83 patients with CP, 92 patients with PDAC, and 20 subjects as a control group. The concentrations of I...
#2Mazhar A. Kanak(VCU: Virginia Commonwealth University)H-Index: 13
Last. Bashoo Naziruddin(Baylor University Medical Center)H-Index: 34
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Total pancreatectomy with islet autotransplantation (TPIAT) is a promising treatment for refractory chronic pancreatitis (CP). Pathological features of CP include progressive fibrosis in pancreas parenchyma, atrophy, and/or ductal occlusion. Complete acinar atrophy (CAA) caused by chronic fibrosis and necroinflammation results in exocrine sufficiency and may influence islet isolation characteristics during TPIAT. In this analysis of patients who underwent TPIAT at our center, we compared transpl...
OBJECTIVE: Little data exist describing the change over time in islet function and glycemic control in patients with chronic pancreatitis (CP). METHODS: In 325 CP patients who underwent 2 mixed meal tolerance tests and/or glycated hemoglobin (HbA1c) levels, we estimated the rate of change in metabolic measures per 6 months and assessed the association between potential risk factors for diabetes and rate of change using multivariate regression models. RESULTS: Per 6-month time, HbA1c increased by...
: A pancreatite cronica (PC) e uma doenca heterogenea, com diferentes etiologias, muitas vezes, com um longo periodo entre o inicio de sintomatologia e a apresentacao clinica classica. A clinica depende do estadio da doenca, sendo que nos estadios iniciais, predominam episodios recorrentes de pancreatite aguda; com a progressao da doenca, os episodios agudos tornam-se menos frequentes, e a dor adota padroes diferentes, podendo inclusive desaparecer; a insuficiencia funcional desenvolve-se 10 a 1...
AIM: To evaluate the influence of hyperglycemia on the progression of autoimmune pancreatitis. METHODS: We induced hyperglycemia by repetitive intraperitoneal (ip) injection of 50 mg/kg streptozotocin in MRL/MpJ mice, which develop autoimmune pancreatitis due to a genetic predisposition. We compared the extent of inflammation (histological score, CD3+ lymphocytes, CD8+ T-cells, CD4+ T-cells, Foxp3+ T-helper cells) in the pancreas of hyperglycemic and normoglycemic mice. We also analyzed the numb...
Introduction Chronic pancreatitis is an inflammatory disease associated with structural and functional damage to the pancreas, causing pain, maldigestion and weight loss and thus worsening the quality of life. Aims and methods Our aim was to find correlations from a multicentre database representing the epidemiological traits, diagnosis and treatment of the disease in Hungary. The Hungarian Pancreatic Study Group collected data prospectively from 2012 to 2014 on patients suffering from chronic p...
#1Wei-Sheng Chung(PRC: China Medical University (PRC))H-Index: 18
#2Cheng-Li Lin(China Medical University (Taiwan))H-Index: 21
Essentials Risks of deep vein thrombosis (DVT) and pulmonary embolism (PE) in chronic pancreatitis (CP) are unclear. We conducted a nationwide cohort study to evaluate the risks of DVT and PE in CP patients. 17 778 patients with CP and 71 106 without CP were followed for 86 740 and 429 116 person-years, respectively. Patients with CP had a 2.95-fold increased rate of DVT and a 4.51-fold increased rate of PE. SummaryBackground Studies on the association between chronic pancreatitis (CP) and cardi...
Autoimmune pancreatitis (AIP) is a distinctive type of pancreatitis, and it is considered that the pathogenesis of AIP involves autoimmune mechanisms [1–6]. Recently, AIP has been considered as a systemic disease because it is often accompanied by various extrapancreatic lesions including cholangitis, sialadenitis, retroperitoneal fibrosis, hilar lymphadenopathy, and chronic thyroiditis [7–11]. Furthermore, AIP is often associated with pancreatic exocrine and endocrine dysfunction. Recently, AIP...
The present study was conducted on biopsy material obtained from 65 patients with complicated chronic pancreatitis and 6 samples of tissue from intact pancreas. Сellular composition, islets’ death and regeneration were analyzed using histological and immunohistochemical methods depending on the fibrous transformation in the development of chronic pancreatitis. Given study provides a detailed description of the histological changes that occur in the pancreas during the development of fibrosis, al...
