Summary
Pancreatic functions were studied in 15 patients with tropical sprue. The diagnosis of tropical sprue was made on accepted criteria of demonstrating malabsorption of at least two unrelated food substances in the absence of any other cause for malabsorption in patients residing in a tropical zone. Exogenous secretin (Boots) in a dose of one clinical unit per kg was employed for direct stimulation of exocrine pancreatic secretion. Of the 15 patients, 12 showed normal pancreatic functions. In two patients, volume output was marginally low i.e. 1.6 and 1.6 ml/kg/hr respectively (Normal value > 1.8 ml/kg/hr). In the third patient, volume output was normal but maximum bicarbonate concentration in pancreatic juice was 61.6 mEq/litre (Normal value >80 mEq/litre). None of these three patients, however, had abnormalities in both the parameters of exocrine pancreatic function. Although pancreatic hyposecretion has been reported in patient with tropical sprue when indirect stimulation with Lundh meal was applied to pancreas, yet on direct stimulation with secretin, we found pancreatic functions to be normal. It is therefore concluded that the pancreas is not primarily involved in tropical sprue.
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References
Ashford BK: Sprue. In Tice Practice of Medicine. Vol IV Hagers Town: 1934, p 173
Baker SJ, Mathan VI: Tropical Sprue. In Modern Trends in Gastroenterology. Butter Worth, London, 1970, p 198
Palagopal G, Jacob R, Swarnabai C, Kapadia CR, Mathan VI, Baker SJ: Secretion of exocrine pancreatic enzymes in patients with tropical sprue, following stimulation by a test meal. Indian J Med Res 63: 1138, 1975
Brown TR: The absence of pancreatic secretion in sprue and the employment of pancreatic extract in the treatment of this disease. Am J Med Sci 161: 501, 1921
DiMagno EP, Go VLW, Summerskill WHJ: Impaired cholecystokinin-pancreozymin secretion, inraluminal dilution and maldigestion of fats in sprue. Gastroenterology 63: 25, 1972
Dreiling DA: The pancreatic secretion in malabsorption syndrome and related malnutrition state. Jr Mt Sinai Hosp 24: 859, 1957
Klipstein FA: Tropical sprue. Gastroenterology 54: 275, 1968
Klipstein FA, Baker SJ: Regarding the definition of tropical sprue. Gastroenterology 58: 717, 1970
Klipstein FA: Tropical Sprue. In Gastroenterology Vol II, 3rd Edition, Ed HL Bockus. Philadelphia, WB Saunders Co, 1974, p 293
Lager HO: Pancreatic Function and Pancreatic Disease Studied by Means of Secretin. The MacMillan Co, New York, 1972
Lundh G: Pancreatic exocrine function in neoplastic and inflammatory disease. A single and reliable test Gastroenterology 42: 275, 1962
Morales H: Sprue. In Gastroenterology, Volume II, 2nd Edition, Ed HL Bockus. Philadelphia, WB Saunders Co, 1966, p 293
Mottable A, Kapp F, Noguera FCA, et al: The Lundh test in the diagnosis of pancreatic disease. A review of 5 years experience. Gut 14: 835, 1973
Tandon BN, George PK, Sama SK, Ramachandran K, Gandhi PC: Exocrine pancreatic function in protein calorie malnutrition disease of adults. Am Jr Cl Nutr 22: 1476, 1969
Tandon BN, Banks RA, George PK, Sama SK, Ramachandran R, Gandhi PC: Exocrine pancreatic function in adult protein calorie malnutrition. Gastroenterology 58: 358, 1969
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Sharma, S.K., Dilawari, J.B. & Anand, B.S. Pancreatic function tests in tropical sprue is pancreas involved?. Gastroenterol Jpn 17, 187–191 (1982). https://doi.org/10.1007/BF02775994
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DOI: https://doi.org/10.1007/BF02775994