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Chronic pancreatitis calcification risk factors

Jorg Kleeff, David C Whitcomb, Tooru Shimosegawa, Irene Esposito, Markus M Lerch, Thomas Gress, Julia Mayerle, Asbjørn Mohr Drewes, Vinciane Rebours, Fatih Akisik, J Enrique Domínguez Muñoz, John P Neoptolemos
Chronic pancreatitis is defined as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Potential causes can include toxic factors (such as alcohol or smoking), metabolic abnormalities, idiopathic mechanisms, genetics, autoimmune responses and obstructive mechanisms. The pathophysiology of chronic pancreatitis is fairly complex and includes acinar cell injury, acinar stress responses, duct dysfunction, persistent or altered inflammation, and/or neuro-immune crosstalk, but these mechanisms are not completely understood...
September 7, 2017: Nature Reviews. Disease Primers
Melena D Bellin, David C Whitcomb, Judah Abberbock, Stuart Sherman, Bimaljit S Sandhu, Timothy B Gardner, Michelle A Anderson, Michele D Lewis, Samer Alkaade, Vikesh K Singh, John Baillie, Peter A Banks, Darwin Conwell, Gregory A Cote, Nalini M Guda, Thiruvengadam Muniraj, Gong Tang, Randall E Brand, Andres Gelrud, Stephen T Amann, Christopher E Forsmark, C Mel Wilcox, Adam Slivka, Dhiraj Yadav
OBJECTIVES: Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies. METHODS: Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers...
September 2017: American Journal of Gastroenterology
Alena Ondrejková, Bohuslav Kianička, Hana Nechutová, Lukáš Hruška, Ivo Novotný, Miroslav Souček
Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, classified into 2 subtypes - AIP type 1 and AIP type 2. We present a case of a 31-years-old female admitted to our institution with upper abdominal pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatoscopy (ERCP) revealed stenosis of intrapancreatic distal bile duct. Diffuse parenchymal enlargement and typical features of AIP were shown by computed tomography (CT) and endoscopic ultrasonography (EUS). The patient´s serum IgG4 was elevated at 3...
December 0: Vnitr̆ní Lékar̆ství
Ahmad Anaizi, Phil A Hart, Darwin L Conwell
Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive in those patients with early changes in CP. The workup of suspected CP should follow a progressively noninvasive to more invasive STEP-wise approach in a patient with a suspicious clinical presentation and risk factors that raise their pretest probability of disease. After a thorough history and physical examination, basic laboratories should be obtained such as lipase, amylase, metabolic panel, and indirect PFTs (fecal elastase-1, serum trypsin)...
July 2017: Digestive Diseases and Sciences
Amir Mohamed, Ahmet Ayav, Arthur Belle, Xavier Orry, Jean-Baptiste Chevaux, Valerie Laurent
OBJECTIVE: Chronic calcifying pancreatitis (CCP) is a risk factor for pancreatic cancer (PC). Symptoms of PC are non-specific in patients with CCP, and diagnostic imaging can be difficult. Some studies have shown that diagnosis may take several months, leading to delays in treatment (Lin et al., 2015; Lennon et al., 2014) [2,3]. The aim of this study was to describe the radiological signs of PC in patients with CCP. METHODS: This retrospective, single-center study was conducted between January 2004 and December 2014...
January 2017: European Journal of Radiology
C Mel Wilcox, Bimaljit S Sandhu, Vikesh Singh, Andres Gelrud, Judah N Abberbock, Stuart Sherman, Gregory A Cote, Samer Al-Kaade, Michelle A Anderson, Timothy B Gardner, Michele D Lewis, Christopher E Forsmark, Nalini M Guda, Joseph Romagnuolo, John Baillie, Stephen T Amann, Thiruvengadam Muniraj, Gong Tang, Darwin L Conwell, Peter A Banks, Randall E Brand, Adam Slivka, David Whitcomb, Dhiraj Yadav
OBJECTIVES: Racial differences in susceptibility and progression of pancreatitis have been reported in epidemiologic studies using administrative or retrospective data. There has been little study, however, on the clinical profile, causes, and outcome of chronic pancreatitis (CP) in black patients. METHODS: We analyzed data on black patients with CP prospectively enrolled in the multicenter North American Pancreatitis Studies from 26 US centers during the years 2000-2014...
October 2016: American Journal of Gastroenterology
J Enrique Domínguez Muñoz, Alfredo José Lucendo Villarín, L Fernando Carballo Álvarez, Jose María Tenías, Julio Iglesias García
OBJECTIVE: To estimate the incidence of chronic pancreatitis in Spain as diagnosed with endoscopic ultrasound (EUS), and to assess the risk factors and complications detected. MATERIAL AND METHOD: A descriptive, observational study of chronic pancreatitis cases diagnosed in Spanish health care centers with an EUS unit. A structured questionnaire was used to evaluate the incidence of the disease (cases identified over 18 months: from January 2011 to June 2012), risk factors, EUS criteria, Rosemont classification, and frequency of local complications...
July 2016: Revista Española de Enfermedades Digestivas
Agnieszka Magdalena Rygiel, Małgorzata Wojnicka-Stolarz, Katarzyna Niepokój, Grzegorz Oracz, Jerzy Bal, Katarzyna Wertheim-Tysarowska, Krzysztof Gutkowski
Chronic pancreatitis (CP) is characterized by progressive damage to the exocrine and endocrine cell structures and pancreatic ducts with subsequent fibrosis of the organ. Patients with no apparent etiological factor are classified as having idiopathic CP (ICP). Genetic studies indicate the importance of mutations in the serine protease inhibitor, Kazal type 1 gene (SPINK1) in the pathogenesis of CP This report describes a case of a 29-year-old Polish-Vietnamese patient with the p.Asn34Ser (p.N34S) homozygous mutation in the SPINK1 gene...
July 2015: Developmental Period Medicine
David C Whitcomb, Luca Frulloni, Pramod Garg, Julia B Greer, Alexander Schneider, Dhiraj Yadav, Tooru Shimosegawa
BACKGROUND: A definition of chronic pancreatitis (CP) is needed for diagnosis and distinguishing CP from other disorders. Previous definitions focused on morphology. Advances in epidemiology, genetics, molecular biology, modeling and other disciplines provide new insights into pathogenesis of CP, and allow CP to be better defined. METHODS: Expert physician-scientists from the United States, India, Europe and Japan reviewed medical and scientific literature and clinical experiences...
March 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Jeong Woo Lee, Ho Gak Kim, Dong Wook Lee, Jimin Han, Hyuk Yong Kwon, Chang Jin Seo, Ji Hye Oh, Joo Hyoung Lee, Jin Tae Jung, Joong Goo Kwon, Eun Young Kim
BACKGROUND/AIMS: Smoking and alcohol intake are two wellknown risk factors for chronic pancreatitis. However, there are few studies examining the association between smoking and changes in computed tomography (CT) findings in chronic pancreatitis. The authors evaluated associations between smoking, drinking and the progression of calcification on CT in chronic pancreatitis. METHODS: In this retrospective study, 59 patients with chronic pancreatitis who had undergone initial and follow-up CT between January 2002 and September 2010 were included...
May 23, 2016: Gut and Liver
Ken Kawabe, Tetsuhide Ito, Hisato Igarashi, Ryoichi Takayanagi
Pancreatic diabetes is secondary diabetes followed by progressions of pancreatic exocrine diseases, such as chronic pancreatitis, pancreatic neoplasm and post-pancreatectomy. Because of destruction and reduction of the pancreatic endocrine and exocrine functional compartments, patients with pancreatic diabetes frequently show malnutrition from maldigestion and malabsorption by insufficiencies in pancreatic digestive enzymes, and show unstable glycemic control and prolonged hypoglycemia by insufficiencies in synthesis and secretion of insulin and glucagon...
February 2009: Clinical Journal of Gastroenterology
Nathan Hitzeman, Erin Cotton
Incidentalomas are increasingly common findings on radiologic studies, causing worry for physicians and patients. Physicians should consider the risk of discovering incidentalomas when contemplating imaging. Patients may assume that incidentalomas are cancer, and may not be aware of the radiation risks associated with repeat imaging. Once incidentalomas are detected, appropriate management is dependent on an informed patient's wishes and the clinical situation. Guidelines are provided for the initial management of eight incidentalomas (pituitary, thyroid, pulmonary, hepatic, pancreatic, adrenal, renal, and ovarian)...
December 1, 2014: American Family Physician
Sarah Jane Schwarzenberg, Melena Bellin, Sohail Z Husain, Monika Ahuja, Bradley Barth, Heather Davis, Peter R Durie, Douglas S Fishman, Steven D Freedman, Cheryl E Gariepy, Matthew J Giefer, Tanja Gonska, Melvin B Heyman, Ryan Himes, Soma Kumar, Veronique D Morinville, Mark E Lowe, Neil E Nuehring, Chee Y Ooi, John F Pohl, David Troendle, Steven L Werlin, Michael Wilschanski, Elizabeth Yen, Aliye Uc
OBJECTIVE: To determine the clinical presentation, diagnostic variables, risk factors, and disease burden in children with chronic pancreatitis. STUDY DESIGN: We performed a cross-sectional study of data from the International Study Group of Pediatric Pancreatitis: In Search for a Cure, a registry of children with acute recurrent pancreatitis and chronic pancreatitis. Between-group differences were compared using Wilcoxon rank-sum test. RESULTS: Among 170 subjects in the registry, 76 (45%) had chronic pancreatitis; 57% were female, 80% were white; median age at diagnosis was 9...
April 2015: Journal of Pediatrics
Sumit Paliwal, Seema Bhaskar, Giriraj R Chandak
Tropical calcific pancreatitis (TCP) is a form of chronic non-alcoholic pancreatitis initially reported in the developing parts of the tropical world. The clinical phenotype of TCP has undergone marked changes since its first description in 1968. The disease is now seen in relatively older people with less severe symptoms. In addition, there are varying reports on the proportion of cases presenting with imaging abnormalities like calcification, ductal dilation, and glandular atrophy. Significant progress has also been made in understanding the etiopathology of TCP...
December 14, 2014: World Journal of Gastroenterology: WJG
Masahiro Maruyama, Takayuki Watanabe, Keita Kanai, Takaya Oguchi, Jumpei Asano, Tetsuya Ito, Yayoi Ozaki, Takashi Muraki, Hideaki Hamano, Norikazu Arakura, Shigeyuki Kawa
Autoimmune pancreatitis (AIP) has been recognized as a distinct type of pancreatitis that is possibly caused by autoimmune mechanisms. AIP is characterized by high serum IgG4 and IgG4-positive plasma cell infiltration in affected pancreatic tissue. Acute phase AIP responds favorably to corticosteroid therapy and results in the amelioration of clinical findings. However, the long-term prognosis and outcome of AIP remain unclear. We have proposed a working hypothesis that AIP can develop into ordinary chronic pancreatitis resembling alcoholic pancreatitis over a long-term course based on several clinical findings, most notably frequent pancreatic stone formation...
2014: Orphanet Journal of Rare Diseases
María Luaces-Regueira, Julio Iglesias-García, Björn Lindkvist, Margarita Castiñeira-Alvariño, Laura Nieto-García, José Lariño-Noia, J Enrique Domínguez-Muñoz
OBJECTIVES: Several recent studies have demonstrated the association between smoking and chronic pancreatitis (CP). However, less is known about the role of smoking in the development of CP-related complications. Our aim was to investigate the impact of smoking and alcohol consumption on age of onset and complications at CP diagnosis. METHODS: A cross-sectional case-case study was performed within a prospectively collected cohort of patients with CP. Alcohol consumption and smoking habits were assessed using a standardized questionnaire...
March 2014: Pancreas
Bechien U Wu, Kartik Sampath, Christopher E Berberian, Karl K Kwok, Brian S Lim, Kevin T Kao, Andrew Q Giap, Anne E Kosco, Yasir M Akmal, Andrew L Difronzo, Wei Yu, Eunis W Ngor
OBJECTIVES: Pancreatic cystic neoplasms (PCNs) are being detected with increased frequency. The aims of this study were to determine the incidence of malignancy and develop an imaging-based system for prediction of malignancy in PCN. METHODS: We conducted a retrospective cohort study of patients ≥18 years of age with confirmed PCN from January 2005 to December 2010 in a community-based integrated care setting in Southern California. Patients with history of acute or chronic pancreatitis were excluded...
January 2014: American Journal of Gastroenterology
Milan R Patel, Amanda L Eppolito, Field F Willingham
Hereditary pancreatitis shares a majority of clinical and morphologic features with chronic alcoholic pancreatitis, but may present at an earlier age. The term hereditary pancreatitis has primarily been associated with mutations in the serine protease 1 gene (PRSS1) which encodes for cationic trypsinogen. PRSS1 mutations account for approximately 68-81% of hereditary pancreatitis. Mutations in other genes, primarily serine protease inhibitor Kazal type 1 (SPINK1) and the cystic fibrosis transmembrane conductance regulator (CFTR) are also associated with hereditary pancreatitis...
March 2013: Therapeutic Advances in Gastroenterology
Mel J Sharafuddin, Rachael M Nicholson, Timothy F Kresowik, Parth B Amin, Jamal J Hoballah, William J Sharp
OBJECTIVE: To evaluate our experience with the endovascular treatment of total occlusions of the mesenteric and celiac arteries. METHODS: We performed a retrospective review of endovascular stenting of 27 nonembolic total occlusions of the superior mesenteric artery (SMA) and celiac artery (CA) between July 2004 and July 2011 (26 patients, 16 females; mean age, 62 ± 13 years). A variety of demographic, lesion-related and procedure-related variables were evaluated for potential impact of technical success and patency...
June 2012: Journal of Vascular Surgery
Cristina Jimeno-Ayllón, José Ignacio Pérez-García, Carmen Julia Gómez-Ruiz, Jesús García-Cano-Lizcano, Julia Morillas-Ariño, Raquel Martínez-Fernández, Lorena Serrano-Sánchez, Ángel Pérez-Sola
AIM: to study the possible differences in the final diagnosis of chronic pancreatitis by using standard classification described by Wiersema et al. and the new classification proposed recently by Rosemont. MATERIAL AND METHODS: forty-seven patients with the diagnosis of chronic pancreatitis were included in this study. The parenchymal and ductal criteria were studied, the patients were divided in two groups for Wiersema criteria: < 4 criteria, non-diagnostic for chronic pancreatitis and ≥ 4 criteria, diagnosis of chronic pancreatitis...
December 2011: Revista Española de Enfermedades Digestivas
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