Summary
Plasma lipase, C-peptide reactivity (CPR) and human pancreatic polypeptide (HPP) responses after ingestion of elemental diet were studied in 27 patients with chronic pancreatitis. These subjects were classified into 3 groups according to ERP findings; minimum or mild (MIP, n=17), moderate (MOP, n=6) and advanced (ADP, n=4). Basal plasma lipase levels in the MIP and MOP patients were significantly higher than that in the controls (P < 0.05). Plasma CPR response (Σ Δ CPR) in MIP cases were significantly higher than that in controls (P < 0.05). Also, plasma HPP response (Σ Δ HPP) in MIP cases were significantly higher than that in controls (P < 0.05). Plasma CPR and HPP responses correlated with the severity of chronic pancreatitis. Fourteen of the 17 MIP patients (82%) showed higher levels of basal lipase or Σ Δ HPP in comparison to the respective normal ranges. This study suggested that the ED test may be more sensitive for detection of mild chronic pancreatitis and that it may be useful for evaluating exocrine and endocrine pancreatic functions in various stages of chronic pancreatitis.
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References
Arvanitakis C, Cook ARDiagnostic tests of exocrine pancreatic function and disease. Gastroenterology 1978;74:932–948.
Lundh G. Pancreatic exocrine function in neoplastic and inflammatory disease; a simple and reliable new test. Gastroenterology 1962;42:275–280.
Arvanitakis C, Greenberger NJ. Diagnosis of pancreatic disease by a synthetic peptide. Lancet 1976;1:663–666.
Ammann RW, Tagwercher E, Kashiwagi H, et al. Diagnostic value of fecal chymotrypsin and trypsin assessment for detection of pancreatic disease. Am J Dig Dis 1968;13:123–146.
Muench R, Ammann R. Fecal Immunoreactive lipase: A new tubeless pancreatic function test. Scand J Gastroenterol 1992;27: 289–294.
Sarner M, Cotton PB. Classification of pancreatitis. Gut 1984;25: 756–759.
Nagai K, Aoyama S, Yamazaki Y. Diagnostic evaluation of provocative plasma pancreatic enzyme test-Plasma lipase response to intravenous bolus injection of secretin. J Jpn Pane Soc 1987;2: 541–547.
Axon ATR, Classen M, Cotton PB, et al. Pancreatography in chronic pancreatitis: international definitions. Gut 1984;25:1107–1112.
Nagai K, Yamazaki Y, Iguchi K, et al. Effects of intravenous secretin on plasma pancreatic polypeptide and lipase activity in man. Biomed Res 1988;9(supple 1):24.
Craft IL, Geddes D, Hyde CW, et al. Absorption and malabsorption of glycine and glycine peptides. Gut 1968;9:425–437.
Ihse I, Arnesjoe B, Kugelberg C, et al. Intestinal activities of trypsin, lipase and phospholipase after a test meal. Scand J Gastroenterol 1977;12:663–668.
Domschke S, Stock KP, Richl J, et al. Beta-cell reserve capacity in chronic pancreatitis. Hepato-gastroenterol 1985;32:27–30.
Orci L, Baetens D, Ravazzola M, et al. Pancreatic polypeptide and glucagon: non-random distribution in pancreatic islets. Life Sci 1976;19:1811–1816.
Nealon WH, Courtney M, Shabot M, et al. Diagnostic role of gastrointestinal hormones in patients with chronic pancreatitis. Ann Surg 1986;204:430–437.
Kloeppel G, Bommer G, Commandeur G, et al. The endocrine pancreas in chronic pancreatitis. Virchows Arch A Oath Anat and Histol 1978;377:157–174.
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Nagai, K., Iguchi, K. & Yanaihara, N. Plasma lipase, C-peptide reactivity and human pancreatic polypeptide responses after ingestion of elemental diet in patients with chronic pancreatitis. Gastroenterol Jpn 28, 401–405 (1993). https://doi.org/10.1007/BF02776985
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DOI: https://doi.org/10.1007/BF02776985