Laboratory Diagnostic Test for Pancreatic Disorders by Examination of Parotid Saliva

Abstract

Laboratory diagnostic tests for pancreatic diseases were carried out by examination of samples of parotid saliva in 22 patients, of whom 9 were with pancreatic disorders and 13 with disorders of other organs or systems. Trend analyses of the data thereby obtained revealed the approximate borderline values (lower for pancreatic diseases and higher for non-pancreatic disorders) for the rate of salivary secretion, its maximum bicarbonate concentration and amylase secretion to be 0.6ml per minute, 20mEq/L, and 1,000 units per kg of body weight, respectively.The results of the present study emphasize potential usefulness of the examination of parotid saliva as a reliable diagnostic means for diseases of the pancreas.pancreas; pancreatitis; parotid gland; amylase; bicarbonate In a previous study of ours evidence had been already obtained for degenera tion of the parotid gland associated with some dysfunction of the parotid, viz. decreased parotid salivary secretion, decline in the maximal bicarbonate concent ration and diminution of amylase secretion, in the presence of pancreatitis or other forms of disorders of the pancreas (Kakizaki et al. 1971; 1972 a, b, c).The present communication deals with the clinical application of these experi mental findings. MATERIAL AND METHODSSubjects: As shown in Table 1, were studied a series of 22 cases, including 9 with pancreatic diseases and 13 with non-pancreatic disorders, and the diagnoses were confirmed upon laparotomy. Collection of saliva samples:With the patient in the lateral position, a saliva-sampling apparatus was attached closely onto the orifice of the parotid on one side and 1% pilocar pine hydrochloride was injected intramuscularly in a dose of 0.13mg per kg. After the parotid saliva began secreting thereby, samples of saliva were collected continuously on 5 consecutive samples for 5minutes each, for 25minutes in total, into a graduated test tube.At the end of the saliva sampling the patient was given an intramuscular dose of 0.13mg atropine sulfate per 10kg of body weight.

Parotid Saliva Test Compared with Pancreozymin-Secretin Test in Diagnosis of Pancreratic Disorders

“…This test was done as previously described (Kakizaki et al 1973a(Kakizaki et al , 1974.The values of this test for normal subjects were 0.204-0.707 ml/kg for the The values outsides these ranges were defined as representing pancreatic diseases.…”

“…We have recently developed a new, simple and rapid test for the diagnosis of pancreatic disorders (Kakizaki et al 1973a(Kakizaki et al , 1974. The rationale of this test was based on the findings in a number of animal and human studies that diminutions in volume, maximum bicarbonate concentration and amylase content of the parotid saliva are well correlated with the presence of pancreatitis as well as with other form of pancreatic diseases (Kakizaki et al 1971(Kakizaki et al , 1972a(Kakizaki et al , b, c, 1973bIshidate et al 1974).…”

Parotid Saliva Test in the Diagnosis of Chronic Pancreatitis

“…In man, Descos et al (2) observed decreased basal but normal stimulated salivary secretion in chronic pancreatitis. In contrast, Kakizaki et al (8,9) found that pilocarpine stimulated volume, maximal bicarbonate con centration and amylase content of the saliva of patients with pancreatic disorders were signifi cantly lower than in patients with nonpancreat ic disorders. Therefore, the parotid saliva test was introduced as a new diagnostic test for pancreatic diseases allegedly superior to the secretin-pancreozymin test.…”

The effect of long term ethanol intake on the parotid gland in rats.

“…251 rats, we demonstrated that a humoral transmission mechanism participates in the development of an interactive response between the pancreas and the parotid gland (Kakizaki et al 1978). On the basis of these findings, we developed a parotid saliva test using the intramuscular injection of 1% pilocarpine hydrochloride as a screening test for the diagnosis of pancreatic disorders, and found that the test was sufficiently reliable and informative to merit an extensive clinical trial (Kakizaki et al 1973(Kakizaki et al , 1976b(Kakizaki et al , 1983. The results of our parotid saliva test have been confirmed by some other authors (Grimmel et al 1976;Nacchiero et al 1978;Noronha et al 1978;Mc Coll et a].. 1979a;Dudar and Gusak 1981;Medizova and Ivanov 1981) and disputed by some (Minaire et al 1975;Dobrilla et al 1979 ;Lankish et al 1979).…”