Exocrine pancreatic insufficiency in tropical sprue.
BACKGROUND
Pancreatic insufficiency may appear secondary to several intestinal disorders. It may contribute to malabsorption in tropical sprue (TS).


METHODS
The exocrine pancreatic function was evaluated with the indirect pancreolauryl test (PT) in 56 patients with TS. The PT results were analyzed and correlated with serum albumin levels, degree of intestinal atrophy, and steatorrhea.


RESULTS
Abnormally low values were found in 36 (64.2%) cases. A significant relationship was not observed between PT and hypoalbuminemia. Patients with more severe damage by intestinal biopsy tended to have lower PT values. No relationship was found between pancreatic insufficiency and steatorrhea (expressed as g/24 h), but patients with pancreatic insufficiency had increased stool fat concentrations (expressed as percentage of wet stool weight). All patients responded favorably to treatment with folic acid and tetracycline. Fifteen patients with abnormal initial PT values underwent a repeat PT after a 6-week therapy; all of them showed normalization of PT values.


CONCLUSIONS
The abnormal exocrine pancreatic function found with an indirect test in patients with TS is probably secondary to a low pancreatic hormonal stimulation due to intestinal damage, as occurs in celiac sprue. These abnormalities are reversible after specific treatment for TS.
Morales
M
M
Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Tlalpan, 14000 Mexico City, Mexico.
Galván
E
E
Mery
C M
CM
Castro
G
G
Uscanga
L F
LF
Robles-Díaz
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis; D001284:Atrophy; D001706:Biopsy; D002446:Celiac Disease / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology / Q000502:physiology*; D010182:Pancreatic Diseases / Q000209:etiology* / Q000503:physiopathology; D012720:Severity of Illness Index; D013182:Sprue, Tropical / Q000150:complications*
D000418:Albumins