title: Prospective evaluation of subjects with chronic asymptomatic pancreatic hyperenzymemia.
abstract: OBJECTIVE
  Chronic asymptomatic pancreatic hyperenzymemia (CAPH) has been described since 1996 as a benign disease. Recent studies described pathological findings at magnetic resonance cholangiopancreatography with secretin stimulation (s-MRCP) in more than half of the CAPH subjects. The aim of this study was to investigate the frequency and clinical relevance of s-MRCP findings in patients with CAPH.
  
  
  METHODS
  Subjects prospectively enrolled from January 2005 to December 2010 underwent s-MRCP and biochemical tests routinely performed.
  
  
  RESULTS
  Data relative to 160 subjects (94 males, 66 females, age 49.6±13.6 years) were analyzed. In all, 51 (32%) subjects had hyperamylasemia, 9 (6%) hyperlipasemia, and 100 (62%) an increase in both enzyme levels. The time between the first increased dosage of serum pancreatic enzymes and our observation was 3.3±3.9 years (range: 1-15). Familial pancreatic hyperenzymemia was observed in 26 out of 133 subjects (19.5%). Anatomic abnormalities of the pancreatic duct system at s-MRCP were found in 24 out of 160 subjects (15%). Pathological MRCP findings were present in 44 subjects (27.5%) before and in 80 subjects (50%) after secretin administration (P<0.0001). Five subjects (3.1%) underwent surgery, 3 for pancreatic endocrine tumor, 1 for pancreatic adenocarcinoma, and 1 for intraductal papillary-mucinous neoplasia (IPMN) involving the main pancreatic duct, and 18 patients (11.3%) needed a follow-up (17 for IPMN and 1 for endocrine tumor).
  
  
  CONCLUSIONS
  Alterations of the pancreatic duct system at s-MRCP in subjects with CAPH can be observed in 50% of the subjects and are clinically relevant in 14.4% of cases.
authors.affiliation: Verona Pancreas Centre, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Amodio
authors.forename: Riccardo
authors.initials: R
authors.lastname: Manfredi
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Katsotourchi
authors.forename: Armando
authors.initials: A
authors.lastname: Gabbrielli
authors.forename: Luigi
authors.initials: L
authors.lastname: Benini
authors.forename: Roberto Pozzi
authors.initials: RP
authors.lastname: Mucelli
authors.forename: Italo
authors.initials: I
authors.lastname: Vantini
authors.forename: Luca
authors.initials: L
authors.lastname: Frulloni
mesh_terms: D000681:Amylases / Q000097:blood; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D049448:Cholangiopancreatography, Magnetic Resonance; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000201:enzymology* / Q000473:pathology; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D008049:Lipase; D000681:Amylases