Exocrine and endocrine pancreatic function in 21 patients suffering from autoimmune pancreatitis before and after steroid treatment.
OBJECTIVE
Autoimmune pancreatitis (AIP) responds rapidly and dramatically to steroid therapy. The aim of this study was to evaluate pancreatic exocrine and endocrine function in patients suffering from AIP both before and after steroid therapy.


METHODS
Fecal elastase 1 and diabetes were evaluated before steroid therapy and within 1 month of its suspension in 21 patients (13 males and 8 females, mean age 43 +/- 16.5 years) diagnosed as having AIP between 2006 and 2008.


RESULTS
At clinical onset, fecal elastase 1 was 107 +/- 126 microg/g stool. Thirteen patients (62%) showed severe pancreatic insufficiency (<100 microg/g stool), 4 (19%) had mild insufficiency (100-200 microg/g stool), while 4 (19%) had normal pancreatic function (>200 microg/g stool). Before steroids, diabetes was diagnosed in 5 patients (24%), all of whom had very low levels of fecal elastase 1 (<19 microg/g stool). Following steroids, fecal elastase 1 increased in all patients (237 +/- 193 microg/g stool) and observed levels were significantly higher than those seen before steroids (p = 0.001).


CONCLUSIONS
Patients suffering from AIP display exocrine and/or endocrine pancreatic insufficiency at clinical onset. These insufficiencies improve after steroid therapy.
Frulloni
Luca
L
Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy. luca.frulloni@univr.it
Scattolini
Chiara
C
Katsotourchi
Anna Maria
AM
Amodio
Antonio
A
Gabbrielli
Armando
A
Zamboni
Giuseppe
G
Benini
Luigi
L
Vantini
Italo
I
D000328:Adult; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000503:physiopathology; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000503:physiopathology*; D010196:Pancreatic Elastase / Q000378:metabolism*; D010195:Pancreatitis / Q000188:drug therapy / Q000503:physiopathology*; D011239:Prednisolone / Q000627:therapeutic use
D011239:Prednisolone; D010196:Pancreatic Elastase