Autonomic nervous function in alcohol-related chronic pancreatitis.
Patients with alcohol-related chronic pancreatitis (ARCP) often have peripheral neuropathy, but no data on the occurrence of autonomic neuropathy (AN) are available for this condition. To assess the autonomic function and the significance of its abnormalities for the prognosis of ARCP, 18 patients with ARCP and associated diabetes mellitus (P-DM group), 10 with ARCP without evidence of diabetes mellitus (P group), 17 patients with insulin-dependent diabetes mellitus (IDDM group), and 18 healthy controls answered a structured questionnaire and underwent three standardized cardiovascular (CV) tests that yielded six different parameters for autonomic nerve function. Patients with at least one symptom plus two abnormal results on CV tests were regarded as having AN. ARCP patients were followed up for 48 months and mortality rates were recorded. The proportions of patients with AN were 66.6% in the P-DM group, 30.0% in the P group, and 29.4% in IDDM patients. Seven of 15 ARCP patients with AN died during follow-up, compared with one of 13 of those without AN (p < 0.037). In conclusion, AN is commonly found in ARCP patients and carries an ominous prognosis.
Rosa-e-Silva
L
L
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil.
Oliveira
R B
RB
Troncon
L E
LE
Foss
M C
MC
Souza
C S
CS
Gallo
L
L
D000293:Adolescent; D000328:Adult; D001146:Arrhythmia, Sinus; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D002908:Chronic Disease; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D019512:Pancreatitis, Alcoholic / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D011187:Posture; D011379:Prognosis; D012018:Reflex; D015996:Survival Rate; D014636:Valsalva Maneuver