Chronic Asymptomatic Pancreatic Hyperenzymemia: A Long-term Follow-up.

Published on Apr 1, 2019in Pancreas2.92
· DOI :10.1097/MPA.0000000000001272
Antonio Amodio13
Estimated H-index: 13
,
Giulia De Marchi6
Estimated H-index: 6
+ 5 AuthorsLuca Frulloni58
Estimated H-index: 58
Sources
Abstract
OBJECTIVES: Chronic asymptomatic pancreatic hyperenzymemia (CAPH) was described as a benign disease. However, we already described clinically relevant findings requiring surgery or follow-up in half of the subjects. The aim of this study was to evaluate the long-term outcome of CAPH in terms of symptoms and evolution toward chronic pancreatitis. METHODS: Subjects previously enrolled in the first phase of the study (from 2005 to 2010) were reinvestigated from December 2013 to January 2017 with a phone call ± magnetic resonance cholangiopancreatography with secretin stimulation. RESULTS: A total of 133 subjects were eligible for the follow-up study (75 males, 58 females; age, 48.4 [standard deviation {SD}, 14] years); 24 (18%) of them dropped out. During a mean follow-up of 9.3 (SD, 5.2) years after the first diagnosis of CAPH, no episode of acute pancreatitis or abdominal pain was reported. Sixty-three subjects (58%) of 109 underwent magnetic resonance cholangiopancreatography with secretin stimulation with a mean follow-up of 5.7 [SD, 3.1] years (range, 1-11 years). Secretin stimulation-MRCP resulted unchanged in 54 (90%) of 60 subjects, worsened in 3 (5%) and improved in 3 (5%). Two subjects died from causes unrelated to pancreatic disease. CONCLUSIONS: Excluding subjects with a pancreatic disease at index magnetic resonance imaging, CAPH is a benign condition.
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#2V. BelfioriH-Index: 3
Last. Raffaele PezzilliH-Index: 54
view all 12 authors...
ObjectivesWe have previously shown that at least 50% of patients with asymptomatic chronic pancreatic hyperenzymemia (ACPH) may develop morphological pancreatic alterations. Endoscopic ultrasonography (EUS) may detect small lesions, and its sensitivity seems to be higher than other imaging technique
5 CitationsSource
#1Luca Frulloni (University of Verona)H-Index: 58
#2Antonio Amodio (University of Verona)H-Index: 13
4 CitationsSource
#1Milena Di Leo (UniSR: Vita-Salute San Raffaele University)H-Index: 17
#2Maria Chiara Petrone (UniSR: Vita-Salute San Raffaele University)H-Index: 19
Last. Alberto Mariani (UniSR: Vita-Salute San Raffaele University)H-Index: 27
view all 7 authors...
Background Magnetic resonance cholangio-pancreatography (MRCP) findings in people with chronic asymptomatic pancreatic hyperenzymemia (CAPH) have shifted the hypothesis that CAPH is always non-pathological. However, there have been no studies including both secretin-MRCP (S-MRCP) and endoscopic ultrasonography (EUS) to examine the pancreatic morphology in these subjects. Aim To prospectively assess the diagnostic approach for CAPH using both pancreatic EUS and S-MRCP. Methods In a case-control p...
8 CitationsSource
RESULTS: Data relative to 160 subjects (94 males, 66 females, age 49.6 ± 13.6 years) were analyzed. In all, 51 (32 % ) subjects had hyperamylasemia, 9 (6 % ) hyperlipasemia, and 100 (62 % ) an increase in both enzyme levels. The time between the fi rst increased dosage of serum pancreatic enzymes and our observation was 3.3 ± 3.9 years (range: 1 - 15). Familial pancreatic hyperenzymemia was observed in 26 out of 133 subjects (19.5 % ). Anatomic abnormalities of the pancreatic duct system at s-MR...
30 CitationsSource
#2Piero BoraschiH-Index: 22
Last. Fabio FalaschiH-Index: 24
view all 9 authors...
Abstract Purpose To assess the diagnostic value of secretin-stimulated MRCP (SS-MRCP) compared with conventional MRCP in asymptomatic patients with mild elevations of pancreatic enzymes. Materials and methods Eighty asymptomatic patients with pancreatic hyperenzymemia underwent MR imaging at 1.5 T-device (Signa EXCITE, GE Healthcare). After the acquisition of axial T1w,T2w sequences, and conventional MRCP, SS-MRCP was performed using a single-slice coronal breath-hold, thick-slab, SSFSE T2w sequ...
20 CitationsSource
Objective. Prospectively to evaluate patients with chronic asymptomatic pancreatic hyperenzymemia in order to identify possible pancreatic and non-pancreatic diseases. Material and methods. Seventy-five asymptomatic subjects with long-standing pancreatic hyperenzymemia (45 M, 30 F; mean age±SD 51.5±16.0 years, range 19–78 years, mean duration±SD of pancreatic hyperenzymemia 14.7±7.0 months, range 7–34 months) and normal ultrasonographic evaluation were included in this study. The subjects enroll...
24 CitationsSource
#1Pier Alberto Testoni (UniSR: Vita-Salute San Raffaele University)H-Index: 39
#2Alberto MarianiH-Index: 6
Last. Enzo MasciH-Index: 27
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Pancreatic Ductal Abnormalities Documented by Secretin-Enhanced MRCP in Asymptomatic Subjects With Chronic Pancreatic Hyperenzymemia
57 CitationsSource
#1Lucio Gullo (UNIBO: University of Bologna)H-Index: 29
#2Laura LucrezioH-Index: 5
Last. P.L. CostaH-Index: 9
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: Benign pancreatic hyperenzymemia is a newly identified syndrome characterized by an abnormal increase in serum pancreatic enzymes in the absence of pancreatic disease. The hyperenzymemia can occur sporadically or in a familial form, and all of the pancreatic enzymes show elevations. Although the condition is persistent, the enzyme elevations fluctuate considerably, even temporarily returning to normal levels at times. In this review the main characteristics of this syndrome are described.
12 CitationsSource
#1Koenraad J. MorteleH-Index: 66
#2Walter Wiesner (Harvard University)H-Index: 15
Last. Stuart G. Silverman (Harvard University)H-Index: 84
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We assessed the magnetic resonance cholangiopancreatographic (MRCP) findings in patients with asymptomatic, mild elevations of serum amylase and lipase levels to determine whether there might be a pathoanatomic cause for these laboratory abnormalities. MRCP was performed in 633 consecutive patients. Of these, 54 (8.5%) images were obtained in patients with asymptomatic serum hyperamylasemia and hyperlipasemia. MRCP was performed on a 1.0-T MR system; breath-hold gradient-recall, half-Fourier acq...
53 CitationsSource
#1Lucio Gullo (UNIBO: University of Bologna)H-Index: 29
Abstract BACKGROUND & AIMS: Pancreatic hyperamylasemia is usually an expression of pancreatic disease. This study describes pancreatic hyperamylasemia in the absence of pancreatic disease. METHODS: Eighteen subjects with this form of hyperamylasemia were referred to our unit from January 1987 to June 1991. Amylase and pancreatic isoamylase as well as serum lipase and trypsin concentrations were determined, and ultrasonography and computed tomography were performed in all patients. After initial ...
61 CitationsSource
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This narrative review summarizes a selection of clinically-important novel gastrointestinal developments, presented and discussed at the virtual Gastro Update Europe. The selected topics, fully referenced, reflect what the distinguished faculty considered of vital importance to be communicated to the astute busy gastro-hep clinician who is eager to stay abreast of important novel developments. Whenever appropriate a personal comment or addition was added to further raise the educational value of...
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