A Study of Spink 1 Mutation and other clinical correlates in idiopathic recurent acute pancreatitis and idiopathic chronic pancreatitis.

Shiran, Shetty (2012) A Study of Spink 1 Mutation and other clinical correlates in idiopathic recurent acute pancreatitis and idiopathic chronic pancreatitis. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.


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INTRODUCTION : Recurrent acute pancreatitis and chronic pancreatitis are labeled as idiopathic when no identifiable factors are found. The identifications of genetic mutations associated with pancreatitis have provided opportunities for identifying patients at risk for idiopathic pancreatitis. Recurrent pancreatitis is defined as two or more attacks of pancreatitis and chronic pancreatitis is defined as a continuing inflammatory disease of the pancreas characterized by irreversible morphological changes and typically causing pain and permanent loss of function. Many studies have been conducted on acute and chronic pancreatitis, but only few have focused on idiopathic chronic and recurrent acute pancreatitis. In clinical practice evaluation fails to detect the cause of pancreatitis in 10 – 30% of the patients, and these patients are labeled as idiopathic chronic and recurrent acute (RAP) pancreatitis. Evaluation is important in such patients since more than 50% of patients with RAP experience recurrent episodes that can lead to chronic pancreatitis. Very few studies have been conducted on idiopathic recurrent acute pancreatitis. RAP can be due to biliary disease, alcohol, trauma, hypercalcemia, hyperlipedemia, or anatomical variations. In clinical practice upto 30% do not have identificable factors and are labeled as idiopathic recurrent pancreatitis. AIM: To study of clinical profile and prevalence of SPINK 1 mutation in idiopathic recurrent acute and chronic pancreatitis. DESIGN: Prospective observational study of patients with idiopathic recurrent and chronic pancreatitis in a tertiary care hospital from November 2010 to 31st December 2011. RESULTS: Fifty patients were included out which 17 patients were idiopathic recurrent acute pancreatitis and 33 were chronic. Out of 17 patients with RAP mean age was 22.29 ± 9.7 years, duration of illness was 28.23 ± 10.34 months, 82% were male, 94% had BMI > 18.5 kg/ m2 41.17% had SPINK1 mutation. Out of 33 patients with chronic pancreatitis mean age was 31.75 ± 13.07 year, duration of illness was 31.33 ± 19.89 months, mean fasting sugar was 112.57 mg/dl, 67% were male, 93.94% had pain 87.8% had ductal dilatation on CT, 36.36% were SPINK 1 positive. CONCLUSION: SPINK1 mutation patients have more frequent episodes of pancreatitis and parenchymal calcification on CT. The clinical profile of idiopathic chronic pancreatitis is different fromwhat has been reported in the past.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Idiopathic Recurrent Acute Pancreatitis ; Chronic Pancreatitis SPINK1 mutation.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 14 Jul 2017 06:34
Last Modified: 14 Jul 2017 06:34
URI: http://repository-tnmgrmu.ac.in/id/eprint/1641

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