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Chronic pancreatitis

Youyou Luo, Jie Chen, Youhong Fang, Jingan Lou, Jindan Yu
BACKGROUND: Autoimmune metaplastic atrophic gastritis is a chronic progressive inflammatory condition. The clinical spectrum includes pernicious anemia, atrophic gastritis, antibodies to parietal cell antigens and intrinsic factor, achlorhydria, hypergastrinemia and carcinoma. It is rare in paediatric cohorts. CASE PRESENTATION: We present the case of a boy with metaplastic atrophic gastritis in whom immune dysregulation, polyendocrinopathy, enteropathy, X-linked(IPEX) syndrome was confirmed by FOXP3 gene mutation...
June 15, 2018: BMC Pediatrics
Qian Sun, Qianlei Yang, Hui Xu, Junchao Xue, Chao Chen, Xingfen Yang, Xiaohua Gao, Qizhan Liu
Chronic exposure to arsenic, a potent environmental oxidative stressor, is associated with the incidence of diabetes. However, the mechanisms for arsenite-induced reduction of insulin remain largely unclear. After CD1 mice were treated with 20 or 40 ppm arsenite in the drinking water for 12 months, the mice showed reduced fasting insulin levels, a depression in glucose clearance, and lower insulin content in the pancreas. The levels of glucose-stimulated insulin secretion (GSIS) in pancreatic β-cells isolated from arsenite-exposed mice were low compared to those for control mice...
June 14, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
Peter M DiGeronimo, Nicholas A Crossland, Angela Jugan, Javier G Nevarez, Thomas N Tully, Dawn E Evans
A 5-year-old sexually intact male Toulouse goose ( Anser anser domesticus) was presented for ataxia, polyuria, and polydipsia. The goose was cachectic and exhibited head tremors. Results of plasma biochemical analysis and point-of-care glucometry revealed persistent hyperglycemia. Despite supportive care and oral glipizide, the goose died within 48 hours of presentation. Necropsy revealed severe pancreatic atrophy and fibrosis with regionally extensive cerebellar encephalomalacia and generalized Purkinje cell degeneration and necrosis...
June 2018: Journal of Avian Medicine and Surgery
Ricardo E De Armas, Jacob M Rosenberg, Andrew Z Fenves
Acute pancreatitis is an inflammatory condition of the pancreas manifesting with abdominal pain and elevated serum levels of pancreatic enzymes. Gallstones and chronic alcohol use are the most commonly described causes. A less studied cause is cholesterolosis, gallbladder polyps that cause mechanical obstruction of the sphincter of Oddi. Here, we present the case of a 55-year-old woman who presented with acute pancreatitis and was found to have cholesterol polyps in her gallbladder with no evidence of gallstones...
July 2018: Proceedings of the Baylor University Medical Center
Travis Haneke, Andrew J Widmer, Austin Metting
We present a case of splenic abscess as a probable complication following endoscopic retrograde cholangiopancreatography (ERCP). Based on a literature review, there have been 11 documented cases of splenic injury following ERCP; however, only one of those involved splenic abscess. Proposed mechanisms of injury and abscess are likely a combination of complicating factors, including manipulation of the endoscope in patients with a history of chronic pancreatitis and/or previous abdominal surgeries.
July 2018: Proceedings of the Baylor University Medical Center
Frank U Weiss, Mariya E Skube, Markus M Lerch
PURPOSE OF REVIEW: Genetic mutations in genes within and outside of the trypsin-dependent pathologic pathway have been found to be associated with chronic pancreatitis. This review highlights recent developments. RECENT FINDINGS: CTRB1-CTRB2 has been identified as a new risk locus for chronic pancreatitis and the disease mechanism may involve trypsin degradation. Misfolding mutations in PRSS1, CPA1, and CEL, as well as environmental stress factors like tobacco and alcohol can trigger endoplasmic reticulum stress (ER-Stress)...
June 8, 2018: Current Opinion in Gastroenterology
Mariya E Skube, Greg J Beilman
PURPOSE OF REVIEW: Patients suffering from chronic pancreatitis often require surgical intervention to treat their disease. This review discusses surgical options as well as reviews current trends and research in the operative management of chronic pancreatitis. RECENT FINDINGS: Relevant current topics in the field include the appropriate timing of surgery as well as the relative benefits of various procedures, particularly duodenum-preserving pancreatic head resection versus pancreaticoduodenectomy...
June 8, 2018: Current Opinion in Gastroenterology
Kendall R McEachron, Melena D Bellin
PURPOSE OF REVIEW: We reviewed the current state of total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis and recurrent acute pancreatitis (RAP). RECENT FINDINGS: An increasing number of centers in the United States and internationally are performing TPIAT. In selected cases, TPIAT may be performed partially or entirely laparoscopically. Islet isolation is usually performed at the same center as the total pancreatectomy surgery, but new data suggest that diabetes outcomes may be nearly as good when a remote center is used for islet isolation...
June 8, 2018: Current Opinion in Gastroenterology
Dorothée Faille, Marie-Charlotte Bourrienne, Emmanuelle de Raucourt, Luc de Chaisemartin, Vanessa Granger, Romaric Lacroix, Laurence Panicot-Dubois, Pascal Hammel, Philippe Lévy, Philippe Ruszniewski, Nadine Ajzenberg, Vinciane Rebours
Background: Venous thrombo-embolic events (VTE) frequently occur in patients with pancreatic ductal adenocarcinoma (PDAC) and contribute to high morbidity and mortality. Objectives: To determine whether VTE biomarkers are related to cancer, inflammation or precancerous states and to assess their relevance to predict VTE in PDAC. Patients and Methods: We compared VTE biomarkers in patients with PDAC ( n = 42), intraductal papillary mucinous neoplasm of the pancreas (IPMN, n = 48) or chronic pancreatitis ( n = 50)...
May 29, 2018: Oncotarget
Georg Beyer, Jan G D'Haese, Steffen Ormanns, Julia Mayerle
Chronic pancreatitis is a fibroinflammatory syndrome of the exocrine pancreas, which is characterized by an increasing incidence, high morbidity and lethality. Common etiologies besides alcohol and nicotine consumption include genetic causes and risk factors. The life time risk for the development of pancreatic cancer is elevated 13- to 45-fold depending on the underlying etiology. In patients with chronic pancreatitis clinical, laboratory and imaging surveillance for early detection of complications, including pancreatic cancer, is recommended, although the available methods lack the desired sensitivity and specificity...
June 2018: Deutsche Medizinische Wochenschrift
Zihan Yan, Zeenat A Shyr, Manuela Fortunato, Alecia Welscher, Mariana Alisio, Michael Martino, Brian N Finck, Hannah Conway, Maria S Remedi
Chronic hyperglycemia has been proposed to cause pancreatic β-cell dysfunction and loss of β-cell mass. As in human monogenic neonatal diabetes, mice expressing KATP channel gain-of-function (GOF) mutations demonstrate deficiency in insulin secretion and develop severe diabetes. As diabetes progresses, they show loss of islet insulin content and β-cell mass, secondary consequences of glucotoxicity. Co-morbidity of chronic hyperglycemia and elevated lipids, so called glucolipotoxicity, is also crucial in the pathogenesis of diabetes...
June 12, 2018: Diabetes, Obesity & Metabolism
Anita Balázs, Zsolt Balla, Balázs Kui, József Maléth, Zoltán Rakonczay, Julia Duerr, Zhe Zhou-Suckow, Jolanthe Schatterny, Matthias Sendler, Julia Mayerle, Jens-P Kühn, László Tiszlavicz, Marcus A Mall, Peter Hegyi
Objective: Defective mucus production in the pancreas may be an important factor in the initiation and progression of chronic pancreatitis (CP), therefore we aimed to (i) investigate the qualitative and quantitative changes of mucus both in human CP and in an experimental pancreatitis model and (ii) to correlate the mucus phenotype with epithelial ion transport function. Design: Utilizing human tissue samples and a murine model of cerulein induced CP we measured pancreatic ductal mucus content by morphometric analysis and the relative expression of different mucins in health and disease...
2018: Frontiers in Physiology
Oscar K Serrano, Kent J Peterson, Tetyana Mettler, Joshua J Wilhelm, Melena D Bellin, Gregory J Beilman, Guru Trikudanathan, Timothy L Pruett, Ty B Dunn
Total pancreatectomy (TP) is a treatment option for patients experiencing chronic pancreatitis (CP) refractory to medical management. Patients who are candidates for TP benefit from islet autotransplantation (IAT), which preserves available β-cell mass and thereby reduces the risk of brittle diabetes. Malignancy is an absolute contraindication for IAT to prevent the transplantation of occult malignant cells. We present the case of a patient with CP who was approved to undergo TP with IAT (TPIAT) but was intraoperatively discovered to have a pancreatic neuroendocrine tumor...
July 2018: Pancreas
Sven M van Dijk, Janneke van Grinsven, G J C Bert van Oostveen, Marco J Bruno, Marc G Besselink
No abstract text is available yet for this article.
July 2018: Lancet. Gastroenterology & Hepatology
Salvador Navarro
Since ancient times the increase of size and hardness sometimes presented by the abdominal structure known as the pancreas has attracted attention. Portal was the first to describe the clinical signs of chronic pancreatitis in 1803. In 1815, Fleischman speculated about the potential role of excessive alcohol consumption. Comfort coined the term "chronic relapsing pancreatitis" in 1946 and described hereditary pancreatitis 6 years later. Zuidema defined tropical pancreatitis in 1959 and 2 years later Sarles described another form of pancreatitis to which Yoshida gave the name autoimmune pancreatitis in 1995...
June 8, 2018: Gastroenterología y Hepatología
John D Lyons, Ching-Wen Chen, Zhe Liang, Wenxiao Zhang, Deena B Chihade, Eileen M Burd, Alton B Farris, Mandy L Ford, Craig Coopersmith
Patients with cancer who develop sepsis have a markedly higher mortality than patients who were healthy prior to the onset of sepsis. Potential mechanisms underlying this difference have previously been examined in two preclinical models of cancer followed by sepsis. Both pancreatic cancer/pneumonia and lung cancer/cecal ligation and puncture (CLP) increase murine mortality, associated with alterations in lymphocyte apoptosis and intestinal integrity. However, pancreatic cancer/pneumonia decreases lymphocyte apoptosis and increases gut apoptosis while lung cancer/CLP increases lymphocyte apoptosis and decreases intestinal proliferation...
June 8, 2018: Shock
J Enrique Dominguez-Muñoz
PURPOSE OF REVIEW: Pancreatic exocrine insufficiency (PEI), defined as a secretion of pancreatic enzymes and bicarbonate insufficient to maintain a normal digestion, is a frequent but frequently underdiagnosed and undertreated condition. PEI may be secondary to different pancreatic diseases and extrapancreatic conditions. Recent data support the high clinical relevance of PEI and its treatment. RECENT FINDINGS: Together with symptoms of maldigestion, PEI is associated with nutritional deficiencies leading to osteoporosis, low-trauma fractures, sarcopenia and increased mortality...
June 7, 2018: Current Opinion in Gastroenterology
Yuki Nakamura, Takahiro Nomi, Keiko Morio, Takuki Sakaguchi, Yuichirou Sasaki, Yoshikazu Murawaki, Hajime Isomoto
A 66-year-old man was hospitalized for diverticular bleeding of the colon. Anticoagulant drugs (Dabigatran and Beraprost sodium), which had been taken for chronic underlying atrial fibrillation, were interrupted for three days. After two months, he presented with acute pancreatitis and a pancreatic pseudocyst. The contrast-enhanced CT scan revealed an atrial thrombus and localized splenic infarction. Consequently, we suspected ischemic acute pancreatitis secondary to thrombus. Anticoagulant drug interruption and the resultant local ischemia were potential factors contributing to ischemic pancreatitis...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Jing Luo, Aihua Wang, Wei Zhen, Yao Wang, Hongwei Si, Zhenquan Jia, Hana Alkhalidy, Zhiyong Cheng, Elizabeth Gilbert, Bin Xu, Dongmin Liu
We previously discovered that phytonutrient genistein rapidly activates cAMP signaling in β-cells and improves islet mass in diabetic mice. However, the mechanism underlying these actions of genistein is still unclear. Here, we show that pharmacological or molecular inhibition of Gαs blocked genistein-stimulated adenylate cyclase activity in plasma membrane and intracellular cAMP production in INS1 cells and islets. Further, genistein stimulation of cAMP generation was abolished in islets exposed to a specific GPR30 inhibitor G15 or islets from GPR30 deficient (GPR30-/-) mice...
May 12, 2018: Journal of Nutritional Biochemistry
Frank Ulrich Weiss, Nico Hesselbarth, Andrea Párniczky, Dora Mosztbacher, Felix Lämmerhirt, Claudia Ruffert, Peter Kovacs, Sebastian Beer, Katharina Seltsam, Heidi Griesmann, Richard Böhme, Tom Kaune, Marcus Hollenbach, Hans-Ulrich Schulz, Peter Simon, Julia Mayerle, Markus M Lerch, Giulia Martina Cavestro, Raffaella Alessia Zuppardo, Milena Di Leo, Pier Alberto Testoni, Ewa Malecka-Panas, Anita Gasirowska, Stanislaw Głuszek, Peter Bugert, Andrea Szentesi, Joachim Mössner, Heiko Witt, Patrick Michl, Peter Hégyi, Markus Scholz, Jonas Rosendahl
BACKGROUND/OBJECTIVES: Acute pancreatitis (AP) is one of the most common gastrointestinal disorders often requiring hospitalization. Frequent aetiologies are gallstones and alcohol abuse. In contrast to chronic pancreatitis (CP) few robust genetic associations have been described. Here we analysed whether common variants in the CLDN2-MORC4 and the PRSS1-PRSS2 locus that increase recurrent AP and CP risk associate with AP. METHODS: We screened 1462 AP patients and 3999 controls with melting curve analysis for SNPs rs10273639 (PRSS1-PRSS2), rs7057398 (RIPPLY), and rs12688220 (MORC4)...
June 1, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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