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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six cases of chronic calcific pancreatitis in Thailand occurring in patients aged 13 to 22 years are reported. Protein malnutrition was a possible aetiologic factor. Abdominal pain was mild to moderate and intermittent and not a presenting feature. Severe diabetes mellitus was present at all. Extensive pancreatic calcification was seeen on abdominal X-ray.
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PMID:Diabetes mellitus and tropical form of chronic calcific pancreatitis in Thailand. 107 Sep 89

Chronic pancreatitis is defined by a persistent destruction of the pancreatic parenchyma replaced by fibrosis. The lesions generally start in the exocrine gland, islets being attacked later in the fibrosis. The two most frequent forms are: 1. Chronic calcifying pancreatitis which is a pancreatic lithiasis responsible for more than 95% of chronic pancreatitis. In its most frequent form, calculi are built up of more than 98% calcium salts together with fibres of a degraded residue of lithostathine, a secretory protein. This disease is related (i) in most countries to alcohol, protein, fat and tobacco and (ii) in certain tropical countries to malnutrition (low-fat, low-protein diet) for some generations. A causative role for cassava and kwashiorkor is improbable. The mechanism of calcium precipitation is partly explained by the calcium-saturation of pancreatic juice and the decreased biosynthesis of lithostathine S, the secretory protein preventing crystallization. As a rule, diabetes (and steatorrhoea) appear after a clinical evolution characterized by recurrent attacks of upper abdominal pain, generally lasting some days with transiently increased concentrations of pancreatic enzymes in serum. When diabetes appears, pain frequently disappears. Complications are mostly observed in the first 10 years of clinical evolution. 2. Obstructive pancreatitis is due to an obstacle (tumours, scars) in the pancreatic duct. It is rarely a cause of diabetes. Diabetes due to chronic pancreatitis is characterized by the low incidence of ketosis and the high incidence of insulin-induced hypoglycaemia. Patients are generally thin. Serum insulin levels, either basal or stimulated, are decreased. Glucagon is less affected. Angiopathies and retinopathies are less frequent than in non-insulin-dependent diabetes. Neural complications are fairly frequent. The diagnosis is generally easy because diabetes appears at a late stage of the disease. The treatment generally requires insulin.
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PMID:Chronic pancreatitis and diabetes. 144 67

One hundred nineteen children, either French or from the Ivory Coast, aged 1-8 years, were submitted to pancreatic function testing by duodenal aspiration. Trypsin, chymotrypsin, lipase, phospholipase, amylase, volume, bicarbonate, chloride, and calcium were estimated before and after an intravenous injection of 1 CU secretin + 3 CHR units pancreozymin per kilogram of body weight. Sixty-two patients were normal European children, and 11 were normal African children. Twenty-five African children presented with kwashiorkor and 10 African children had presented with kwashiorkor but had recovered at the time of the test. Three cases of recurrent kwashiorkor are also included. In the normal group of African children, phospholipase concentration, volume, and bicarbonate were significantly decreased but chymotrypsin and trypsin concentrations were not, when compared to the normal European population. In kwashiorkor patients, lipase, amylase, phospholipase, and chymotrypsin concentration were significantly decreased compared to normal Africans. Trypsin, volume, and bicarbonate were not affected. These modifications disappeared after refeeding. In cases of recurrent kwashiorkor, all enzymes, including trypsin, were decreased. Calcium was never modified. These modifications were very different from those observed in chronic alcoholic and hypercalcemic pancreatitis. In a two-year study, chronic calcifying pancreatitis (CCP) was diagnosed in 14 patients (13 males), hospitalized in Abidjan. The mean age at onset of the disease was 41 years (SD 12.71), which is very similar to European cases. The most frequent cause was alcoholism, as in Occidental countries. The nutrition of the population was low in protein, calories being provided mostly by manioc, but no apparent symptoms of malnutrition were observed in the parents of our patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Exocrine pancreatic function of children from the Ivory Coast compared to French children. Effect of kwashiorkor. 300 10

The most current form of chronic pancreatitis, i.e. chronic calcifying pancreatitis, is often related to nutritional causes. This disease is characterized by formation within the pancreatic ducts and the lumina of accini of precipitates and calculi composed of calcium carbonate and of a newly discovered protein, the pancreatic stone protein (PSP). The formation of precipitates depends on two mechanisms: (1) a non etiological disorder reducing the secretion of PSP. This small phosphoglycoprotein is a calcium stabilizer which prevents the crystallization of calcium carbonate in a super saturated solution such as pancreatic juice, (2) modifications of the pancreatic juice related to the cause of the disease. In Occidental countries the main etiological factor is alcohol consumption associated with protein-and-fat-rich or fat-poor diets. Like hypercalcaemia, another cause of the disease, a chronic consumption of alcohol increases the pancreatic secretion of secretory proteins (enzymes) via its action on the cholinergic nerves. In some tropical countries, chronic pancreatitis is observed in children and associated to malnutrition. However, according to recent studies neither kwashiorkor nor manioc consumption seem to be responsible for the occurrence of this disease.
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PMID:[Etiopathogenesis of chronic nutritional pancreatitis]. 330 3

The usual consumption of calories, fat, protein, and carbohydrate, and the exocrine pancreatic function estimated in duodenal juice after an intravenous injection of secretin and cholecystokinin (CCK), have been studied with the same method and by the same team in Kerala (South India) and in Marseille (France) in apparently normal children (7 Indians, 21 French), in normal adults (23 Indians, 17 French), and in patients presenting with chronic calcifying pancreatitis (8 Indian children, 28 Indian adults, 25 French adults). Although they had a low protein intake (children controls: 32.1 +/- 14 g/day (SM), children pancreatitis: 51.1 +/- 15, adult controls: 51.3 +/- 4.9, adult pancreatitis: 55.7 +/- 5.7), the exocrine secretion of Indian controls was not very much modified in comparison with Europeans. Therefore, Indians are less affected by the insufficient diet than the population of Ivory Coast previously studied by the same group. The diet of Indian patients is characterized by a moderately low protein intake and a very low fat intake (18.5 g/day +/- 2.3 (SM) for children 23.4 g/day + 2.7 for adult patients). Comparison between different series of patients studied in different countries with the same method suggests that kwashiorkor or cassava consumption have no evident role in the etiology of chronic tropical pancreatitis. The possible role of a low fat diet is suggested and needs further exploration.
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PMID:Diet, pancreatic function, and chronic pancreatitis in south India and France. 336 42

Tropical clacific pancreatitis can be accompanied by varying degrees of malnutrition but full-blown kwashiorkor is an extremely rare presentation. We report the case of a 10-year-old male who presented with clinical features of severe kwashiorkor. He had extensive pancreatic clacification and exocrine pancreatic deficiency. The child was treated with pancreatic enzyme replacement, and enteral nutrition supplemented with vitamins and micronutrients. Following therapy, he started gaining weight, the skin changes partly disappeared and his hair resumed its normal black colour.
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PMID:Tropical calcific pancreatitis presenting as kwashiorkor. 1591 80