Author/Editor		Vujasinović, Miroslav; Tepeš, Bojan; Volfand, Jasna; Rudolf, Saša
Title		Exocrine pancreatic insufficiency, MRI of the pancreas and serum nutritional markers in patients with coeliac disease
Type		članek
Vol. and No.		Letnik 91, št. 1079
Publication year		2015
Volume		str. 497-500
ISSN		1469-0756 - Postgraduate medical journal
Language		eng
Abstract		Objectives To determine whether exocrine pancreatic function is impaired in patients with coeliac disease (CD) in our population and to evaluate its clinical importance. Methods Pancreatic exocrine function was determined by measuring faecal elastase-1 (FE) concentration. CD was diagnosed by serological testing using IgA anti-tissue transglutaminase antibody (IgAtTg) and small bowel biopsy using the Marsh classification. MRI of the pancreas was performed to evaluate any morphological changes. The study took place from January 2012 to December 2013. Results 90 patients (73 women and 17 men) of mean age 43.8+-17.7 years (range 20-80) were included in the study. Mean time from CD confirmation was 5.8+-0.7 years (range 1-25). Exocrine pancreatic insufficiency (EPI) was diagnosed in four (4.4%) patients (one with mild EPI and three with severe EPI). MRI showed no morphological changes in any of the four patients. In all patients with EPI at least one serological nutritional marker was below the lower limit of normal. Conclusions EPI is present in a small number of patients with CD. EPI should be excluded in all patients with CD in the presence of overt malnutrition or in cases of persistent gastrointestinal symptoms despite a gluten-free diet. Measurement of a serum nutritional panel, regardless of the presence of clinical symptoms of EPI, can be of clinical importance. MRI should be performed to exclude any morphological change in the pancreas.
Keywords		pancreas exocrine pancreatic function coeliac diseas