ORIGINAL ARTICLE   

Minerva Gastroenterologica e Dietologica 2020 March;66(1):17-22

DOI: 10.23736/S1121-421X.19.02636-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Pancreatic exocrine insufficiency and Crohn’s disease

Aleksandra HEDSTRÖM ¹, Corinna STEINER ¹, Roberto VALENTE ¹, Stephan L. HAAS ¹, J.-Matthias LÖHR ^{1, 2}, Miroslav VUJASINOVIC ¹ ✉

¹ Department for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden; ² Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden

BACKGROUND: According to the European evidence-based consensus, published by European Crohn’s and Colitis Organization (ECCO), diseases of the pancreas are included as extra-intestinal manifestations in IBD in the forms of acute pancreatitis (AP), chronic pancreatitis (CP), autoimmune pancreatitis (AIP), pancreatic duct abnormalities and pancreatic exocrine insufficiency (PEI). Presence of pancreatic autoantibodies directed against the exocrine of the pancreas has been reported in about one-third of CD. However, association between CD and PEI is not fully elucidated.
METHODS: Patients with a diagnosis of CD were recruited at the Department for Digestive Diseases at Karolinska University Hospital in Stockholm, Sweden. Demographic, clinical and laboratory data were analyzed. Fecal elastase-1 (FE-1) measurements were performed using the enzyme-linked immunosorbent assay (ELISA) method.
RESULTS: There were 20 patients included in the study, 13 (65%) males and 7 (35%) females, mean age 48.3±1.4 years (range 29-67 years). Mean duration of CD was 15.7±2.1 years (range 1-40 years). There were 11 (55%) patients without history of bowel surgery and 9 (45%) patients after ileocecal resection. FE-1 test was normal in all patients, among them 15 (75%) patients with the values of FE-1>500.
CONCLUSIONS: Fecal elastase-1 level was normal in all patients with CD strongly indicated absence of PEI in this group of patients.

KEY WORDS: Exocrine pancreatic insufficiency; Crohn disease; Pancreatic elastase; Chymotrypsin