title: Evidence of pancreatic neuropathy and neuropathic pain in hereditary chronic pancreatitis.
abstract: Increased neural density and neural hypertrophy are characteristic features of pancreatic neuropathy in chronic pancreatitis. Here, we present the extraordinary case of prominent pancreatic neuropathy in a 21-year-old female patient with hereditary chronic pancreatitis and intractable pain who underwent total pancreatectomy. The histopathological analysis demonstrated remnant pancreatic tissue which was only composed of prominent intrapancreatic nerves and fibrosis, without any visible remaining functional pancreatic parenchyma. These histological alterations, including nerve hypertrophy and increased neural density, are known for different aetiologies of chronic pancreatitis, e.g. alcoholic, idiopathic and tropic pancreatitis. However, this is the first report of a patient with hereditary chronic pancreatitis demonstrating the characteristic features of pancreatic neuropathy and neuropathic pain.
authors.affiliation: Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Tieftrunk
authors.forename: Ihsan Ekin
authors.initials: IE
authors.lastname: Demir
authors.forename: Peter
authors.initials: P
authors.lastname: Simon
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.forename: Güralp O
authors.initials: GO
authors.lastname: Ceyhan
mesh_terms: D005260:Female; D005355:Fibrosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D009437:Neuralgia / Q000209:etiology* / Q000628:therapy; D010147:Pain Measurement; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000150:complications*; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000235:genetics* / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D055815:Young Adult
keywords: Chronic pancreatitis; Hereditary pancreatitis; Neuropathic pain; Neuropathy; Neuroplasticity