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Isolation of pancreatic enzymes in the intestine

Jul 14th 2014 at 7:28 PM

Detection of elevated concentrations of pancreatic enzymes in serum generally in the direction inclining physician diagnosis of chronic pancreatitis.

However, as shown by the material, and diabetes can be reduced secretion of pancreatic enzymes in the intestines, while a moderate increase in the concentration of these enzymes in serum.

Frequency of the secondary (developed after many years of diabetes), chronic pancreatitis but is to survey large numbers of patients with diabetes about 5%.

Needs to be discussed another aspect of the problem of diabetes and pancreatitis ratio - a combination of diabetic coma and acute pancreatitis.

A considerable part of the authors consider such descriptions primary acute pancreatitis and suggest that carbohydrate metabolism with ketoacidosis are always secondary.

However, gradually accumulate data that sometimes ratios and sequence of development when combined diabetic coma and acute pancreatitis may be different.

Collected from the literature 57 cases of diabetic coma and a combination of acute pancreatitis only 18 were obtained convincing evidence of the absence of signs of diabetes are of acute pancreatitis. We were able to observe and describe the combination of 6 cases of acute

pancreatitis and diabetic ketoacidosis with high hyperglycemia when subsequent dynamic examination (and in two cases

- and materials to observation of acute pancreatitis) allowed considered secondary acute pancreatitis caused by diabetes.

In one case, the patient was delivered 16 years to the surgical ward with a clinical picture of "acute abdomen" and subjected to laparotomy during which installed acute catarrhal pancreatitis.

The phenomenon of microangiopathy in the pancreas

In the postoperative period was first discovered high hyperglycemia in urine - sugar and acetone. Therapy has undertaken to bring the patient from a state of severe ketoacidosis. Later revealed normal for juvenile diabetes mellitus with the development of 6 years of diabetic retinopathy

. In other cases, we observed the subsequent 2-7-year-old speaker also pointed to the fact that the episode was acute pancreatitis during decompensated diabetes. In 2 cases, acute pancreatitis with a picture of

"acute abdomen" emerged against the background of already previously recognized diabetes (both youth, heavy flow) in violation of the sick and develop insulin regime concerning ketoacidosis

. Acute pancreatitis in these cases manifested severe abdominal pain syndrome, increased diastasuria and a significant increase in the concentrations of serum amylase and trypsin. Of course,

not every case is a combination of acute pancreatitis and diabetic ketoacidosis primarily due to diabetes,

but such a possibility in clinical practice should be considered in the differential diagnosis of this condition and the urgent appointment of rational therapy.

In relation to chronic pancreatitis, in some cases developing diabetes duration, interesting information about the significance of this phenomenon in the genesis of microvascular complications in the pancreas

, a large frequency of detection in the blood of patients with diabetes autoantibodies against pancreatic tissue - in 32 of 75 patients. Since the methodology used in the preparation of the antigen detected antibodies against insulin is not

, but mainly against the exocrine gland tissue, one would think the important role of immunopathological processes in the pathology department of cancer in diabetic patients. However, studies in which passive hemagglutination

reaction put an antigen of pancreatic tissue died from accidental injury of a healthy person, only 6 of the 53 patients with diabetes were able to identify autoantibodies against this antigen in convincing credits (more than 1:16),

and only in one case - titre 1:128, in other titer was lower. In addition, only one patient with diabetes of autoantibodies against six antigen from pancreatic disorders have found enzymatic activity of the exocrine gland tissue, and in many patients with pathology of the enzyme was not autoantibodies.   

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