Familial Aggregation in Tropical Fibrocalculous Pancreatic Diabetes

Mohan, V.; Chari, Suresh T.; Hitman, G. A.; Suresh, Shubha; Madanagopalan, N; Ramachandran, Ambady; Viswanathan, M

doi:10.1097/00006676-198912000-00006

Cited by 53 publications

(29 citation statements)

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“…While speckled calcification was the main feature in the CACP group (71.4% of CACP vs 39.6% of CCPT), a high percentage of patients with CCPT had coarse calcium plaques distributed in the more central parts of the glands (85% of CCPT vs 12% of CACP). Similar observations have been reported in Indian studies [4,20]. …”

Section: Radiological Featuressupporting

confidence: 92%

Descriptive study of chronic calcific pancreatitis in Sri Lanka

Silva

Selliah²,

Thabrew

2010

Ceylon Med. J.

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Objectives To describe the potential risk factors, clinical features, biochemical and radiological features, and management of chronic calcific pancreatitis.Design Cross-sectional descriptive study.Setting Tertiary care general hospital.Patients Fifty patients with pancreatic calcification referred to the Colombo South Teaching Hospital, and 50 agematched controls from healthy relatives or friends of the patients.Measurement Height and weight measurements, immunoreactive insulin levels and trypsin levels of duodenal aspirates were estimated. Plain abdominal xray and ultrasonography were performed.Intervention Endoscopic retrograde cholangiopancreaticography (ERCP) was attempted on all patients during which duodenal aspirates were collected. Success rates of ERCP and response to endotherapeutic procedures were recorded.Results Twenty two of the 50 chronic calcific pancreatitis (CP) patients were diagnosed to have chronic alcoholic calcific pancreatitis (CACP). Mean age of the CACP patients was significantly higher than that of the chronic calcific pancreatitis of the tropics (CCPT) patients. Severe malnutrition (BMI < 20), frequent consumption of Manihot esculenta (manioc, cassava) and a high consumption of chilli or pepper were identified as possible risk factors for both alcoholic and non-alcoholic CP. Onset of diabetes occurred at a much younger age in the CCPT group than in the CACP group. Mean serum insulin was significantly higher in the CCPT group than in the CACP group and duodenal trypsin level was significantly lower in the CCPT than in CACP group.Conclusions Our results confirm the existence of both alcoholic (CACP) and non-alcoholic (CCPT) types of chronic calcific pancreatitis in Sri Lanka. A larger study is required to confirm the associated risk factors such as Manihot esculenta and foods with a high content of chilli or pepper. IntroductionChronic pancreatitis (CP) is a disease that can lead to many serious complications such as jaundice, duodenal obstruction, pseudocyst, haemorrhage, diabetes, and cancer of the pancreas [1,2]. Presence of pancreatic calculi is a hallmark of chronic pancreatitis [3 ]. Chronic alcohol abuse is the most common cause of chronic calcific pancreatitis in the west [3,4], although only 5-10% of alcoholics develop CP. This suggests that other factors are important in its pathogenesis [5]. An idiopathic, nonalcoholic form of chronic calcific pancreatitis, referred to as chronic calcific pancreatitis of the tropics (CCPT), has been reported from south India and other tropical and sub-tropical regions of the world [6]. CCPT is the most common cause of CP in India [4,7,8]. CCPT is characterised by recurrent abdominal pain and extensive pancreatic calcification in younger age groups. Genetic predisposition, malnutrition, cyanogenic alkaloids derived from Manihot esculenta and other sources have been implicated as important risk factors associated with the pathogenesis of this condition [9][10][11]. However, malnutrition and M. esculenta consumption as risk factors for ...

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Section: Radiological Featuressupporting

confidence: 92%

Descriptive study of chronic calcific pancreatitis in Sri Lanka

Silva

Selliah²,

Thabrew

2010

Ceylon Med. J.

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“…2,4,5 The aetiology of FCPD is likely to be multifactorial, involving both environmental and genetic factors . 2,[6][7][8] Our previous work in south Indians with FCPD, using case-control studies, reported an HLA-DQB1 restriction fragment length polymorphisms (RFLP) association with FCPD pain, 6 similar to that found in type 1 diabetes (T1DM). That study also found an association with the hypervariable region in the 5Ј flanking region of the insulin gene (INS), with 40% of FCPD patients possessing the class 3 allele compared with 9.5% of control subjects; similar to that found in type 2 diabetes (T2DM) in the same ethnic group.…”

Section: Introductionmentioning

confidence: 77%

Genetic susceptibility to fibrocalculous pancreatic diabetes in Bangladeshi subjects: a family study

et al. 2002

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“…Tropical calcific pancreatitis (TCP) is an idiopathic, juvenile, nonalcoholic form of chronic pancreatitis with a unique geographical distribution, while fibro-calculous pancreatic diabetes (FCPD) is a condition, characterized by the development of diabetes secondary to TCP. A genetic etiology for TCP and FCPD has been suggested from its familial aggregation and geographical distribution (94)(95)(96). However, comprehensive screening for Reg IA gene rules out association with TCP and FCPD (97,98).…”

Section: Islet Regeneration and Diabetesmentioning

confidence: 99%

Pancreatic Stone Protein/Regenerating Protein Family in Pancreatic and Gastrointestinal Diseases

Jin

Hayakawa

et al. 2011

Intern. Med.

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Pancreatic stone protein (PSP; reported in 1979), pancreatitis-associated protein (PAP; 1984) and regenerating protein (Reg I;1988) were discovered independently in the fields of the exocrine (pancreatitis) and endocrine (diabetes) pancreas. Subsequent analysis revealed that PSP and Reg I are identical and PAP belongs to the same protein family. PSP/Reg I and PAP share a selective and specific trypsin cleavage site and result in insoluble fibrils (PTP, PATP). Search for a functional role of PSP had led to the idea that it might serve as an inhibitor in pancreatic stone formation and PSP was renamed lithostathine. Inhibitory effects of lithostathine in stone formation have been questioned. Evidence so far obtained can support a lithogenic role rather than a lithostatic role of PSP. PAP and its isoforms have been investigated mainly regarding responses to inflammation and stress. Reg I and its isoforms have been examined on regeneration, growth and mitogenesis in gastrointestinal neoplastic diseases as well as diabetes. Evidence obtained can be applied in the prediction of prognosis and therapy for inflammatory and neoplastic diseases.

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Familial Aggregation in Tropical Fibrocalculous Pancreatic Diabetes

Cited by 53 publications

References 0 publications

Descriptive study of chronic calcific pancreatitis in Sri Lanka

Descriptive study of chronic calcific pancreatitis in Sri Lanka

Genetic susceptibility to fibrocalculous pancreatic diabetes in Bangladeshi subjects: a family study

Pancreatic Stone Protein/Regenerating Protein Family in Pancreatic and Gastrointestinal Diseases

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