Cystic fibrosis transmembrane conductance regulator ion channel function testing in recurrent acute pancreatitis.
OBJECTIVE
To understand the relationship between acute recurrent pancreatitis and cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction.


BACKGROUND
An emerging number of patients present with a nonclassic phenotype of cystic fibrosis (CF) with partial features or single-organ disease only. The association between the phenotype of recurrent pancreatitis CFTR dysfunction is unclear.


METHODS
Patients with idiopathic recurrent pancreatitis were referred for electrophysiologic investigation.


RESULTS
Thirty-three patients (18 males) aged 20+/-12 years with recurrent pancreatitis were studied. Three patients had mild asthma and 1 patient had mild ulcerative colitis. There was no family history of CF. All patients had normal imaging of the pancreatic duct by endoscopic retrograde cholangiopancreatography or magnetic resonance cholangiopancreatography. No patient was pancreatic insufficient. Mean sweat chloride values were 41+/-14 meq/L (range: 18 to 64). Nasal potential difference (NPD) measurement was pathologic in 7 patients. Mean basal potential difference in these 7 patients was -33+/-13 mV and there was an abnormal response to chloride-free and isoproterenol solutions. There was no difference in sweat chloride concentration between the 2 groups. Mutation analysis revealed W1282X/5T, D1152H/5T, and W1282X/- in 3 patients with abnormal NPD and 1 W1282X allele was found in 1 patient with normal NPD.


CONCLUSIONS
In this series, 21% of patients with recurrent pancreatitis have abnormalities of CFTR function. Patients presenting with recurrent, "idiopathic" pancreatitis require CFTR function testing.
Segal
Idit
I
CF Center, Hadassah University Hospital, Jerusalem, Israel.
Yaakov
Yasmin
Y
Adler
Samuel N
SN
Blau
Hannah
H
Broide
Efrat
E
Santo
Moshe
M
Yahav
Yaakov
Y
Klar
Aharon
A
Lerner
Aaron
A
Aviram
Micha
M
Ellis
Ian
I
Mountford
Roger
R
Shteyer
Eyal
E
Kerem
Eitan
E
Wilschanski
Michael
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D018118:Chloride Channels / Q000378:metabolism; D002712:Chlorides / Q000032:analysis / Q000378:metabolism; D003550:Cystic Fibrosis / Q000150:complications / Q000235:genetics / Q000503:physiopathology; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics / Q000502:physiology*; D004594:Electrophysiology; D005260:Female; D006801:Humans; D017136:Ion Transport; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism; D010179:Pancreas / Q000002:abnormalities; D010195:Pancreatitis / Q000150:complications / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology*; D012008:Recurrence; D013542:Sweat / Q000737:chemistry
C505032:CFTR protein, human; D018118:Chloride Channels; D002712:Chlorides; D019005:Cystic Fibrosis Transmembrane Conductance Regulator