Early chronic pancreatitis: is a clinical diagnosis possible?
PDF (Русский)
DOCX (Українська)
DOCX

Keywords

chronic pancreatitis, early pancreatitis, diagnosis, visualization, functional state of the pancreas, biomarkers, treatment

How to Cite

Gubergrits, N. B., Byelyayeva, N. V., Klochkov, A. Y., Lukashevich, G. M., & Rachmetova, V. S. (2019). Early chronic pancreatitis: is a clinical diagnosis possible?. Herald of Pancreatic Club, 44(3), 33-41. https://doi.org/10.33149/vkp.2019.03.03

Abstract views: 238
PDF Downloads: 163 PDF Downloads: 48 PDF Downloads: 61

Abstract

A “fatal chain” in pancreatology is discussed in the present article; peculiar attention is paid to an early chronic pancreatitis (CP), being one of the little-studied “links” in this range and corresponding to the latent period of CP(persistence of inflammation with the presence of biomarkers of CP, which does not meet the diagnostic criteria of proven or late CP, as well as the appearance of signs of exocrine pancreatic insufficiency in the form of reduced functional test results to 70% of normal). Features of the different stages of the pancreatic diseases’ course are presented, substantiatinganeed for a practical identification of the “early CP” diagnosis: "for" - the possibility of timely diagnosis, the identification of patients with an increased risk of prostate cancer; "against": the lack of specific antifibrotic, anti-inflammatory therapy, an increase in financial costs, no impact on the clinical outcome.Advantages and disadvantages of using the “early CP” diagnosis in practice are considered. The authors cite the provisions of the International Consensus on early CP, and list the current diagnostic criteria for this diseaseelaborated by the Japanese Pancreas Society. Advantages and disadvantagesof the instrumental and laboratory diagnostic methods are analyzed, including probable early CP biomarkers (interleukin-8, prostaglandin E2). The most suitable therapeutic tactics for management of patients with early CP are presented, including correction of the exocrine and endocrinepancreatic function, as well as the use of antifibrotic drugs.

https://doi.org/10.33149/vkp.2019.03.03
PDF (Русский)
DOCX (Українська)
DOCX

References

1. Губергриц Н.Б., Беляева Н.В., Фоменко П.Г. «Роковая цепочка»: и в панкреатологии тоже. Сучаснагастроентерологія. 2016. № 5. С. 76 –86.
2. Мудрые мысли о медицине и врачевании: изречения, афоризмы, цитаты. Автор композиции Я. С. Циммерман. 4-е изд., доп. Москва: ГЭОТАР-Медиа, 2015. 256 с.
3. Практическая гепатология. Под ред. акад. РАМН Н. А. Мухина. Материалы «Школы гепатолога», проводимой на базе клиники нефрологии, внутренних и профессиональных заболеваний им. Е. М. Тареева ММА им. И. М. Сеченова. Москва, 2004. 294 с.
4. Abu Dayyeh B. K., Conwell D., Buttar N. S., Kadilaya V., Hart P. A., Baumann N. A. Pancreatic juice prostaglandin E2 concentrations are elevated in chronic pancreatitis and improve detection of early disease. ClinTranslGastroenterol. 2015. Vol. 2, No 6. P. e72.
5. Howes N. R., Lerch M. M., Greenhalf W. Clinical and genetic characteristics of hereditary pancreatitis in Europe. Clin. Gastroenterol. Hepatol. 2004. Vol. 2, No 3. P. 252−261.
6. Iglesias-García J., Lariño-Noia J., Abdulkader-Nallib I., Lindkvist B., Domínguez-Muñoz J. E. Endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) with the Procore™ needle provides inadequate material for the histological diagnosis of early chronic pancreatitis.Rev EspEnferm Dig. 2018. Vol. 110, No 8. Р. 510–514.
7. Ito T., Ishiguro H., Ohara H., Kamisawa T., Sakagami.J, Sata N. Evidence based clinical practice guidelines for chronic pancreatitis 2015. J Gastroenterol. 2016. Vol. 51, No 2. Р. 85–92.
8. Ito T., Kataoka K., Irisawa A., Hirota M., Miyakawa H., Okazaki K. Prospective follow-up study of the patients with early CP or possible CP (The final report of the RCIPD chaired by Shimosegawa T). The RCIPD Report. 2015.Vol. 145. P. e9. (In Japanese) Presented by Shimosegawa T. “Clinical diagnostic criteria for early chronic pancreatitis.” Presentation at the international (IAP/EPC/APA/JPS) chronic pancreatitis guidelines working group meeting; the 47th meeting of the Japanese pancreatic society. Sendai, Japan, 6 August 2016 (In English).
9. Ketwaroo G., Brown A., Young B. Defining the accuracy of secretin pancreatic function testing in patients with suspected early chronic pancreatitis. Am J Gastroenterol. 2013. Vol. 108, No 8. Р. 1360–1366.
10. Lara L. F., Takita M., Burdick J. S., DeMarco D. C., Pimentel R. R., Erim T., Levy M. F. A study of the clinical utility of a 20-minute secretin-stimulated endoscopic pancreas function test and performance according to clinical variables.GastrointestEndosc. 2017. Vol. 86, No 6. Р. 1048–1055.
11. Machicado J. D., Chari S. T., Timmons L., Tang G., Yadav D. A population-based evaluation of the natural history of chronic pancreatitis.Pancreatology. 2018. Vol. 18, No 1. Р. 39–45.
12. Masamune A., Kikuta K., Hamada S., Nakano E., Kume K., Inui A., Shimizu T., Takeyama Y., Nio M., Shimosegawa T. Nationwide epidemiological survey of early chronic pancreatitis in Japan. J Gastroenterol. 2018. Vol. 53, No 1. Р. 152–160.
13. Noh K. W., Pungpapong S., Wallace M. B., Woodward T. A., Raimondo M. Do cytokine concentrations in pancreatic juice predict the presence of pancreatic diseases? ClinGastroenterolHepatol.2006. Vol. 4, No 6. Р. 782–789.
14. Pancreatitis: medical and surgical management. Ed. D. B. Adams. Chichester: Wiley Blackwell, 2017. 326 p.
15. Pancreatology: a clinical casebook. Eds.: T. B. Gardner, K. D. Smith. Cham (Switzerland): Springer International Publishing AG, 2017. 193 p.
16. Sheel A. R.G., Baron R. D., Sarantitis I., Ramesh J. The diagnostic value of Rosemont and Japanese diagnostic criteria for ‘indeterminate’, ‘suggestive’, ‘possible’ and ‘early’ chronic pancreatitis.Pancreatology. 2018. Vol. 18, No 7. Р. 774–784.
17. Stamm B.H. Incidence and diagnostic significance of minor pathologic changes in the adult pancreas at autopsy: a systematic study of 112 autopsies in patients without known pancreatic disease. Hum Pathol. 1984. Vol. 15, No 7. Р. 677–683.
18. The Pancreas: an integrated textbook of basic science, medicine and surgery. Eds.: H. G. Beger, A. L. Warshaw, R. H. Hruban. Oxford: Willey Blackwell, 2018. 1173 p.
19. Van Geenen E. J., Smits M. M., Schreuder T. C., van der Peet D. L., Bloemena E., Mulder C. J. Smoking is related to pancreatic fibrosis in humans. Am J Gastroenterol. 2011. Vol. 106, No 6. Р. 1161–1166.
20. Whitcomb D. C., Frulloni L., Garg P. Chronic pancreatitis: an international draft consensus proposal for a new mechanistic definition. Pancreatology. 2016. Vol. 16, No 2. P. 218−224.
21. Whitcomb D. C., Shimosegawa T., Chari S.T. International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club.Pancreatology. 2018. Vol. 18. Р. 516–527.
22. Wilcox C. M., Yadav D., Ye T., Gardner T. B., Gelrud A., Sandhu B. S.Chronic pancreatitis pain pattern and severity are independent of abdominal imaging findings. ClinGastroenterolHepatol. 2015. Vol. 13, No 3. Р. 552–560.