M Ganesh Kamath1, C Ganesh Pai2, Asha Kamath3. 1. Department of Physiology, Melaka Manipal Medical College, Manipal University, Madhav Nagar, Manipal, 576 104, India. 2. Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal University, Madhav Nagar, Manipal, 576 104, India. cgpai@yahoo.co.in. 3. Department of Community Medicine, Kasturba Medical College, Manipal University, Madhav Nagar, Manipal, 576 104, India.
Abstract
BACKGROUND: Little data exist on the progression of recurrent acute (RAP) and chronic pancreatitis (CP) from regions from where the entity of tropical chronic pancreatitis was originally described. The study aimed to follow up patients with RAP and CP seen at a southern Indian centre for progression of disease over time. METHODS: Prospectively enrolled patients with RAP and CP were followed up, and the alcoholic and idiopathic subgroups were assessed for progression of structural and functional changes in the organ. RESULTS: One hundred and forty patients (RAP = 44; 31.4 %, CP = 96; 68.5 %) were followed up over a median 12.2 (interquartile range 12.0-16.8) months. The cause was alcohol in 31 (22.1 %) and not evident in 109 (77.8 %). The disease progressed from RAP to CP in 7 (15.9 %), 6 (16.2 %) out of 37 in the idiopathic and 1 (14.2 %; p = 1.00) out of 7 in the alcoholic subgroups. Three (42.8 %) and 1 (14.2 %) developed steatorrhea and diabetes mellitus (DM), respectively, and 2 (4.5 %) developed calcification. Established CP progressed in 19 (19.7 %), 1 (1.0 %), 5 (5.2 %), 2 (2.0 %) and 11 (11.4 %) newly developed DM, steatorrhea, calcification and duct dilation during follow up. Among the idiopathic and alcoholic CP, disease progression was seen in 15 (20.8 %) out of 72 and 4 (16.6 %) out of 24 respectively. CONCLUSIONS: Idiopathic RAP and CP progressed during the short-term follow up. This is similar to other etiological forms of pancreatitis, as described from elsewhere in the world.
BACKGROUND: Little data exist on the progression of recurrent acute (RAP) and chronic pancreatitis (CP) from regions from where the entity of tropical chronic pancreatitis was originally described. The study aimed to follow up patients with RAP and CP seen at a southern Indian centre for progression of disease over time. METHODS: Prospectively enrolled patients with RAP and CP were followed up, and the alcoholic and idiopathic subgroups were assessed for progression of structural and functional changes in the organ. RESULTS: One hundred and forty patients (RAP = 44; 31.4 %, CP = 96; 68.5 %) were followed up over a median 12.2 (interquartile range 12.0-16.8) months. The cause was alcohol in 31 (22.1 %) and not evident in 109 (77.8 %). The disease progressed from RAP to CP in 7 (15.9 %), 6 (16.2 %) out of 37 in the idiopathic and 1 (14.2 %; p = 1.00) out of 7 in the alcoholic subgroups. Three (42.8 %) and 1 (14.2 %) developed steatorrhea and diabetes mellitus (DM), respectively, and 2 (4.5 %) developed calcification. Established CP progressed in 19 (19.7 %), 1 (1.0 %), 5 (5.2 %), 2 (2.0 %) and 11 (11.4 %) newly developed DM, steatorrhea, calcification and duct dilation during follow up. Among the idiopathic and alcoholic CP, disease progression was seen in 15 (20.8 %) out of 72 and 4 (16.6 %) out of 24 respectively. CONCLUSIONS: Idiopathic RAP and CP progressed during the short-term follow up. This is similar to other etiological forms of pancreatitis, as described from elsewhere in the world.
Authors: Marc F Catalano; Anand Sahai; Michael Levy; Joseph Romagnuolo; Maurits Wiersema; William Brugge; Martin Freeman; Kenji Yamao; Marcia Canto; Lyndon V Hernandez Journal: Gastrointest Endosc Date: 2009-02-24 Impact factor: 9.427
Authors: Darwin L Conwell; Linda S Lee; Dhiraj Yadav; Daniel S Longnecker; Frank H Miller; Koenraad J Mortele; Michael J Levy; Richard Kwon; John G Lieb; Tyler Stevens; Phillip P Toskes; Timothy B Gardner; Andres Gelrud; Bechien U Wu; Christopher E Forsmark; Santhi S Vege Journal: Pancreas Date: 2014-11 Impact factor: 3.327
Authors: Manuel Méndez-Bailón; Jose María de Miguel Yanes; Rodrigo Jiménez-García; Valentin Hernández-Barrera; Napoleón Pérez-Farinós; Ana López-de-Andrés Journal: Pancreatology Date: 2014-11-29 Impact factor: 3.996
Authors: Paul Georg Lankisch; Nils Breuer; Anja Bruns; Bettina Weber-Dany; Albert B Lowenfels; Patrick Maisonneuve Journal: Am J Gastroenterol Date: 2009-07-14 Impact factor: 10.864