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Author Melitas, Constantine ♦ Meiselman, Mick
Source Directory of Open Access Journals (DOAJ)
Content type Text
Publisher Karger Publishers
File Format HTM / HTML
Date Created 2018-07-04
Copyright Year ©2018
Language English
Subject Domain (in LCC) RC799-869
Subject Keyword Metabolic syndrome ♦ Chronic pancreatitis ♦ Pancreatic steatosis ♦ Internal medicine ♦ Hypertriglyceridemia ♦ Diseases of the digestive system ♦ Medicine ♦ Metabolic pancreatitis ♦ Gastroenterology ♦ Specialties of internal medicine
Abstract Obesity, insulin resistance, and metabolic syndrome continue to increase in prevalence. Hypertriglyceridemia is commonly associated and represents a valuable marker of metabolic syndrome. An increase in subcutaneous fat deposition places patients at risk for visceral adipose deposition in sites such as the liver, heart, and pancreas. Pancreatic steatosis in the setting of metabolic syndrome is a rapidly emerging entity whose clinical spectrum remains to be defined. Hypertriglyceridemia is an accepted cause of acute pancreatitis but its role in chronic pancreatic injury remains to be explored. We present 3 patients with chronic abdominal pain and pancreatic steatosis in the setting of underlying metabolic syndrome with hypertriglyceridemia. These cases were identified in one endoscopic ultrasonographer’s practice over a 12-month period. Each patient had documented hypertriglyceridemia but no history of acute hypertriglyceride-induced pancreatitis. A history of significant alcohol exposure was carefully excluded. Each patient underwent endoscopic ultrasonography (EUS) which proved critical in delineating the spectrum of chronic pancreatic injury. Each of our patients had EUS documentation of pancreatic steatosis and sufficient criteria to establish a diagnosis of chronic pancreatitis. Intraductal pancreatic calculi were identified in all 3 patients. Our series suggests that in the setting of metabolic syndrome, chronic hypertriglyceridemia and pancreatic steatosis may be associated with chronic pancreatitis. We hypothesize that hypertriglyceridemia may provide a pathogenic role in the development of chronic pancreatic microinjury. In addition, each of our patients had EUS-documented pancreatic ductal lithiasis. To our review, these are novel findings which have yet to be reported. We believe that with an enhanced awareness, it is likely that the entity of metabolic syndrome with features of pancreatic steatosis and hypertriglyceridemia with their associated manifestations of chronic pancreatitis, including ductal lithiasis, will be widely appreciated.
ISSN 16620631
Age Range 18 to 22 years ♦ above 22 year
Educational Use Research
Education Level UG and PG ♦ Career/Technical Study
Learning Resource Type Article
Publisher Date 2018-06-01
e-ISSN 16620631
Journal Case Reports in Gastroenterology
Volume Number 12
Issue Number 2
Page Count 6
Starting Page 331
Ending Page 336


Source: Directory of Open Access Journals (DOAJ)