From the Literature: Pancreatitis

Review the recently published results of three studies that looked at both acute and chronic pancreatitis.

Glucagon Suppression during OGTT Worsens While Suppression During IVGTT Sustains Alongside Development of Glucose Intolerance in Patients with Chronic Pancreatitis

Journal: Regulatory Peptides (September 24, 2010)

Authors: Knop F, Vilsboll T, Larsen S, et al

Purpose: “To examine plasma glucagon responses to oral and intravenous (iv) glucose in patients with chronic pancreatitis (CP) and either normal glucose tolerance (NGT), secondary impaired glucose tolerance (IGT) or secondary diabetes mellitus (DM).”

Results: Researchers noted “significant differences (increasing with the degree of glucose intolerance) in glucagon responses during the first hour of OGTT compared to IVGTT,” suggesting “along with the development of secondary glucose intolerance in patients with CP, the suppression of glucagon by oral glucose is gradually lost and substituted by a paradoxical stimulation of secretion, while the suppression by iv glucose is maintained. This might indicate a glucagon stimulatory mechanism of gastrointestinal origin in CP patients.”

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The Role of Acute Pancreatitis in Pediatric Burn Patients

Journal: Burns (September 20, 2010)

Authors: Jeschke M

Purpose: Because “few publications recognize acute pancreatitis as a complication after large burns…the incidence and outcome of acute pancreatitis after burn in children is not well defined.” Accordingly, Jeschke sought “to determine the incidence, morbidity, and mortality relating to acute pancreatitis in a pediatric burn population and to correlate clinical diagnosis with autopsy findings to determine the incidence of unrecognized pancreatitis.”

Results: Jeschke “evaluated autopsy reports of 78 children who died from burns, looking for reported evidence of pancreatic inflammation, and fat/parenchymal necrosis,” while 171 burned children served as controls. Although incidence was low (0.05%), “mortality [was] significantly higher for the acute pancreatitis group vs. the control group.” This, Jeschke writes, “underlines the importance of increased vigilance in the evaluation and treatment of pancreatitis in burned children.”

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Magnetic Resonance Imaging versus Acute Physiology And Chronic Healthy Evaluation II Score in Predicting the Severity of Acute Pancreatitis

Journal: European Journal of Radiology (September 16, 2010)

Authors: Zeng N, Pan H, Feng Z, Xu X

Purpose: “To study the correlation between established magnetic resonance (MR) imaging criteria of disease severity in acute pancreatitis and the Acute Physiology And Chronic Healthy Evaluation II (APACHE II) score, and to assess the utility of each prognostic indicators in acute pancreatitis.”

Results: The MR severity index was “superior to APACHE II in assessing local complications from pancreatitis but has a limited role in determining systemic complications in which the APACHE II score excels.”

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