Effect of secretin on serum pancreatic enzymes and on the Wirsung duct in chronic nonpathological pancreatic hyperenzymemia.
OBJECTIVE
Chronic nonpathological pancreatic hyperenzymemia (CNPH) is a new syndrome characterized by an increase in serum pancreatic enzymes in the absence of pancreatic disease. The aim of this study was to increase our understanding of this condition by determining the serum pancreatic enzyme response as well as changes in the caliber of the Wirsung duct after secretin stimulation.


METHODS
Twenty subjects with CNPH and 9 healthy subjects without CNPH were studied. Blood samples were drawn 5 and 0 min before and 5, 10, 15, 30, 45, and 60 min after intravenous injection of secretin (1 U/kg). Amylase, pancreatic isoamylase, and lipase concentrations were determined. The caliber of the Wirsung duct was measured by ultrasonography.


RESULTS
The injection of secretin caused a marked and statistically significant (p < 0.05) increase in serum pancreatic enzymes in the subjects with CNPH that persisted for the duration of the study. The increase over the basal value was in the range of 1.2- to 1.6-fold for amylase, 1.4- to 2.1-fold for pancreatic isoamylase, and 2.6- to 4.2-fold for lipase. In the control subjects the increase was mild, but statistically significant (p < 0.05), ranging from 1.1- to 1.2-fold for amylase, 1.2- to 1.4-fold for pancreatic isoamylase, and 1.5- to 2.2-fold for lipase. The injection of secretin caused a slight increase in the diameter of the Wirsung duct in both groups of subjects, but this was statistically significant only during the first 30 min of the study.


CONCLUSIONS
The serum pancreatic enzyme response to secretin was more marked in CNPH than in controls. The Wirsung duct showed no alterations after secretin injection that would help to explain the hyperenzymemia.
Gullo
Lucio
L
Department of Internal Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. gullo@med.unibo.it
Ventrucci
Maurizio
M
Barakat
Bahjat
B
Migliori
Marina
M
Tomassetti
Paola
P
Pezzilli
Raffaele
R
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007517:Isoamylase / Q000097:blood*; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000201:enzymology*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000187:drug effects*; D012633:Secretin / Q000008:administration & dosage / Q000494:pharmacology*; D013577:Syndrome; D014463:Ultrasonography
D012633:Secretin; D008049:Lipase; D007517:Isoamylase