Clinical profile of idiopathic chronic pancreatitis in North India.
OBJECTIVE
Tropical pancreatitis, a form of idiopathic chronic pancreatitis (ICP) with unique features, has been described in South and North India. We investigated the clinical profile of ICP patients in North India.


METHODS
Detailed demographic data were recorded; hematological and biochemical analyses were performed on samples from 155 patients (mostly from North India) who had been diagnosed with chronic pancreatitis. Ultrasonography and computed tomography were performed on all patients. Magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, glucose tolerance tests, and fecal fat studies were performed on some patients. Patients were divided into groups based on early- or late-onset ICP (before or after 35 years of age).


RESULTS
ICP was reported in 41.3% of patients and alcoholic chronic pancreatitis in 38.1%. The mean age of ICP patients was 33.0 +/- 13.0 years and the mean duration of symptoms at the time of presentation was 40.2 +/- 34.4 months. Pain was the dominant symptom in patients with early- (95.1%) and late-onset (100%) ICP; pseudocyst was the most common local complication. Diabetes was observed in 17.1% of patients with early-onset ICP and 34.8% with late-onset ICP. Pancreatic calcification was noted in 46.3% of patients with early-onset and 47.8% with late-onset ICP. Pseudocyst and segmental portal hypertension occurred more frequently in non-calcific ICP, whereas diabetes mellitus and abnormal fecal fat excretion occurred more frequently in patients with calcific ICP.


CONCLUSIONS
In North India, ICP differs from the classical tropical pancreatitis described in the literature. It is associated with a higher prevalence of pain and lower frequencies of diabetes, calcification, and intraductal calculi.
Bhasin
Deepak K
DK
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. dkbhasind@hotmail.com
Singh
Gursewak
G
Rana
Surinder S
SS
Chowdry
Shoket M
SM
Shafiq
Nusrat
N
Malhotra
Samir
S
Sinha
Saroj K
SK
Nagi
Birinder
B
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002114:Calcinosis / Q000209:etiology; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010192:Pancreatic Pseudocyst / Q000209:etiology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology*; D011859:Radiography; D055815:Young Adult