Acute Pancreatitis

Pitchumoni, C. S.

doi:10.1007/978-1-4419-1623-5_43

Cited by 3 publications

(7 citation statements)

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“…There is a shift in the disease pattern in our study showing involvement of middle aged males, which is in line with other published data. [356] Diabetes in patients with TP may have a slow progressive course. It is usually ketosis resistant and is termed as fibro calcific pancreatic diabetes and follows an aggressive course to reach the endpoints of diabetes, pancreatic calculi and exocrine pancreatic dysfunction (steatorrhea) in the majority of cases.…”

Section: Discussionmentioning

confidence: 99%

“…It is well-known that derangement of glucose metabolism is found frequently in all forms of hyperparathyroidism. [610] This can be explained as follows — when PTH is high it produces elevation in intracellular calcium levels that impairs post receptor binding insulin action, such as the dephosphorylation of glycogen synthase and of insulin regulatable glucose transporter-4. [111213] Another possible mechanism is that elevated intracellular calcium enhances calmodulin binding to insulin receptor substrate-1, which interferes with insulin-stimulated tyrosine phosphorylation and phosphatidylinositide 3-kinase activation.…”

Section: Discussionmentioning

confidence: 99%

“…[6] Studies have suggested that parathyroidectomy has cured and prevented the recurrence of pancreatitis, but cause and effect relationship still remains controversial. [56] PHPT can be scintigraphically evaluated using one or more radiopharmaceuticals like 201 Thallium or 99m Technetium (Tc) labeled Sesta methoxy isobutyl isonitrile (MIBI)/tetrofosmin.…”

Section: Introductionmentioning

confidence: 99%

“…reported the association of PHPT and TP in Kerala to be only 7% with a male preponderance in 1970's. [6] To our knowledge, there are no studies in literature that have used scintigraphy as a tool in evaluation of TP patients with raised serum parathormone (PTH).…”

Section: Introductionmentioning

confidence: 99%

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Parathyroid scintigraphy, histopathology correlation in patients with tropical pancreatitis and coexisting primary hyperparathyroidism

Subramanyam

Sundaram

2013

Indian J Nucl Med

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Purpose:Tropical pancreatitis (TP) is a juvenile, non-alcoholic type of chronic pancreatitis and is highly prevalent in Kerala, India. Increasing prevalence of TP and its varied manifestations prompted us to undertake this retrospective analysis. We attempted to study the incidence of TP in patients with primary hyperparathyroidism (PHPT) and correlate with calcium levels, scintigraphy and histopathology findings.Materials and Methods:Records of 44 hypercalcemic patients with raised parathormone (PTH) were analyzed. Clinical, biochemical and imaging findings were noted to look for diabetes mellitus and pancreatitis. All patients underwent dual phase 99m Technetium methoxy isobutyl isonitrile parathyroid scintigraphy in our department between January 2007 and 2010. Gamma probe assisted minimally invasive parathyroidectomy was performed. Histopathological correlation was obtained in all patients.Results:Our study shows 18% (8/44 patients) incidence of TP in patients with PHPT (compared to 7% reported in 1970's) in Kerala. Results show involvement of middle aged, non-alcoholic males. No direct association between severity of diabetes, pancreatitis and PHPT was noted in our series. Parathyroid adenoma was the most common underlying pathology. All TP patients’ clinical outcome improved post parathyroidectomy. TP patients with PHPT demonstrated adenomas, mainly composed of oxyphilic cells. Non pancreatitis group interestingly showed a varied picture of adenoma, hyperplasia with predominance of chief cells histologically.Conclusion:There is a 2.6 fold increase in the incidence of TP (18%) in patients with PHPT. Hypercalcemia may be the causative factor leading to TP in PHPT patients in our limited series. The data suggests a causal association between pancreatitis and PHPT. Patients presenting with either one or a combination of hypercalcemia, pancreatic dysfunction or raised PTH need to be thoroughly evaluated as their management is interlinked.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Parathyroid scintigraphy, histopathology correlation in patients with tropical pancreatitis and coexisting primary hyperparathyroidism

Subramanyam

Sundaram

2013

Indian J Nucl Med

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“…Analysis of pancreatic juice collected following stimulation by secretin and pancreozymin (secretin-pancreozymin test) shows gross reduction of volume, bicarbonate, trypsin and lipase content [52]. ''Tubeless'' tests for exocrine pancreatic function include the bentiromide-para-aminobenzoic acid (BT-PABA) test, fecal chymotrypsin assay and fecal elastase assay.…”

Section: Diagnosismentioning

confidence: 99%

Fibrocalculous pancreatic diabetes (FCPD)

Unnikrishnan

Mohan

2014

Acta Diabetol

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Fibrocalculous pancreatic diabetes (FCPD) is an uncommon form of diabetes that occurs as a result of chronic calcific pancreatitis, in the absence of alcohol abuse. The disease is restricted to tropical regions of the world, and southern India has the highest known prevalence of FCPD. The typical patient with FCPD is a lean adolescent or young adult of either sex, presenting with history of recurrent bouts of abdominal pain and steatorrhea. Demonstration of large, discrete pancreatic calculi by plain radiographs or ultrasonography of the abdomen is diagnostic. While the exact etiology of FCPD is unknown, genetic, nutritional and inflammatory factors have been hypothesized to play a role. Diabetes in FCPD is often brittle and difficult to control; most patients require multiple doses of insulin for control of glycemia. However, in spite of high blood glucose levels, patients rarely develop ketosis. Malabsorption responds to pancreatic enzyme supplementation. Surgical removal of stones is indicated for symptomatic relief of intractable pain. While patients with FCPD develop microvascular complications as frequently as those with type 2 diabetes, macrovascular disease is uncommon. Development of pancreatic malignancy is the most dreaded complication and should be suspected in any patient who complains of weight loss, back pain or jaundice.

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Mechanistic insights into the pathogenesis and management of acute pancreatitis

Michel

Gamal²,

Tadros³

2022

Archives of Pharmaceutical Sciences Ain Shams University

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Acute pancreatitis (AP) is an inflammatory disorder of the pancreas; its incidence rate is increasing worldwide; it is around 34 cases per 100,000 persons /year. It may range from mild to severe cases and may be associated with morbidity and mortality mainly due to multiple organ dysfunction syndromes (MODS). Till now, there is no specific therapy for the disease and the treatment of AP is mainly supportive. Moreover, the underlying mechanisms included in its pathogenesis are not fully clear. However, it may include oxidative stress and inflammatory response, including critical mediators, such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), toll-like receptor-4 (TLR-4), nuclear factor-kappa B (NF-κB), and high-mobility group box protein1 (HMGB1). Thus, there is a pressing need for continuous search in this era to clarify different pathogenesis and the development of new treatment options for AP, also understanding the disease. While research on the human pancreas remains challenging, animal models of AP may help to elucidate the disease pathophysiology & to discover new target options for the development of new therapies. This review aims to revise several aspects related to AP diagnosis and management and to summarize different animal models of AP.

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Acute Pancreatitis

Cited by 3 publications

References 83 publications

Parathyroid scintigraphy, histopathology correlation in patients with tropical pancreatitis and coexisting primary hyperparathyroidism

Parathyroid scintigraphy, histopathology correlation in patients with tropical pancreatitis and coexisting primary hyperparathyroidism

Fibrocalculous pancreatic diabetes (FCPD)

Mechanistic insights into the pathogenesis and management of acute pancreatitis

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