Pancreatita cronică și afecțiunile gastroduodenale -unele tangențe etiologice și clinice
Cuvinte cheie:
PC, afecțiuni gastriceRezumat
Pancreatita cronică (PC) este un proces enigmatic de patogeneză incertă, curs clinic imprevizibil și tratament dificil. În ultimele decenii, au apărut tot mai multe dovezi argumentate ale relațiilor afectărilor pancreatice cu bolile gastroduodenale. S-a propus studierea tangențelor etiologice și clinice ale PC și patologiile gastroduodenale și reflectarea lor prin analiza surselor biblografice. PC și unele boli gastroduodenale au suficiente dovezi de asociere prin simptome clinice similare și diferite căi patologice, care pot include factori de mediu, metabolici, infecțioși, autoimuni, obstructivi. Infecția cu H. pylori poate fi implicată în dezvoltarea și evoluția PC, în secreția pancreatică exocrină a pancreasului, iar PC poate influența fiziologia gastrointestinală cu colonizarea, în consecință, a patogenului. H. pylori ar putea fi implicat în pancreatita autoimună (PAI), în principal prin inducerea autoimunității, prin mimetizare moleculară și apoptoză. PAI se asociază cu afectarea poliorganică, inclusiv și a stomacului, prin dezvoltarea gastritelor, ulcerelor și a polipilor gastrici. Pancreatita, atât acută cât și cronică, este asociată, cu complicații variate. Complicațiile gastrointestinale, deși mai puțin frecvente, sunt încă o cauză semnificativă pentru creșterea morbidității și a spitalizării în cursul clinic al unui pacient. Diagnosticul precoce al acestor complicații este uneori dificil și necesită o abordare clinico-paraclinică complexă și oportună.
Referințe
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https://doi.org/10.1007/s10096-012-1773-9
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https://doi.org/10.1111/j.1582-4934.2005.tb00349.x
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https://doi.org/10.1097/MPA.0b013e3182142fd2
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https://doi.org/10.1016/j.cgh.2007.04.023
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https://doi.org/10.1097/MPA.0b013e31819b5f3c
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https://doi.org/10.1055/s-2005-870369
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https://doi.org/10.1016/j.gie.2009.07.023
17. Kubota K. et al. Clinical significance of swollen duodenal papilla in autoimmune pancreatitis. Pancreas. 2007 Nov;35(4):e51-60. doi: 10.1097/mpa.0b013e31812575b4.
https://doi.org/10.1097/mpa.0b013e31812575b4
18. Crosara S. et al. Autoimmune pancreatitis: Multimodality non-invasive imaging diagnosis World J Gastroenterol. 2014 Dec 7; 20(45): 16881-16890.
https://doi.org/10.3748/wjg.v20.i45.16881
19. Bansal A. et al. Gastrointestinal complications in acute and chronic pancreatitis JGH Open. 2019 Dec; 3(6): 450-455.
https://doi.org/10.1002/jgh3.12185
20. Ramsey ML, Conwell DL, Hart PA. Complications of chronic pancreatitis. Dig. Dis. Sci. 2017; 62: 1745-50.
https://doi.org/10.1007/s10620-017-4518-x
21. Oza VM, Skeans JM, Muscarella P et al Groove pancreatitis, a masquerading yet distinct clinicopathological entity: analysis of risk factors and differentiation. Pancreas. 2015; 44: 901-8.
https://doi.org/10.1097/MPA.0000000000000351
22. Ferreira A., Ramalho M., Herédia V., R. de Campos, P. Marques Groove pancreatitis: a case report and review of the literature. J Radiol Case Rep. 2010; 4(11): 9-17.
https://doi.org/10.3941/jrcr.v4i11.588
23. Howes, N. et al. Clinical and genetic characteristics of hereditary pancreatitis in Europe. Clin. Gastroenterol. Hepatol. 2, 252-261 (2004).
https://doi.org/10.1016/S1542-3565(04)00013-8
24. Chen, Xin; Yang, Mo; Wang, Bangmao. A Case of Acute Hypertrophic Gastritis With Pancreatitis and Allergic Purpura.American Journal of Gastroenterology: October 2014 - Volume 109 - Issue - p S44-S45 PMID: 9516396. https://doi.org/10.1016/S0016-5085(98)70589-X
7. Di Campli C, Nocente R, Costamagna G, Gentiloni N, Burioni R, Wu J, Armuzzi A, Zern MA, Gasbarrini G, Gasbarrini A. No evidence of Helicobacter pylori sequences in pancreatic juices of patients affected by chronic pancreatitis. Int J Pancreatol. 2000 Dec;28(3):181-5. PMID: 11373055. https://doi.org/10.1385/IJGC:28:3:181
8. Manes G, Dominguez-Muñoz JE, Hackelsberger A, Leodolter A, Rössner A, Malfertheiner P. Prevalence of Helicobacter pylori infection and gastric mucosal abnormalities in chronic pancreatitis. Am J Gastro enterol. 1998 Jul;93(7):1097-100. PMID: 9672337. https://doi.org/10.1111/j.1572-0241.1998.336_b.x
9. Regan PT, Malagelada JR, Dimagno EP, Go VL. Postprandial gastric function in pancreatic insufficiency. Gut. 1979 Mar;20(3):249-54. PMID: 35448; PMCID: PMC1412313. https://doi.org/10.1136/gut.20.3.249
10. Niemann T, Larsen S, Mouritsen EA, Thorsgaard N. Helicobacter pylori infection in patients with chronic pancreatitis and duodenal ulcer. Scand J Gastroenterol. 1997 Dec;32(12):1201-3. PMID: 9438316. https://doi.org/10.3109/00365529709028147
11. Shimosegawa T, Chari ST, Frulloni L, et al; International Association of Pancreatology. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas. 2011;40(3):352-358. https://doi.org/10.1097/MPA.0b013e3182142fd2
12. Baez JC., et al. Gastric involvement in autoimmune pancreatitis: MDCT and histopathologic features. JOP. 2010 Nov 9;11(6):610-3
13. Deheragoda M, Church N, Rodriguez-Justo M, Munson P, Sandanayake N, Seward E, et al. The use of immunoglobulin G4 immunostaining in diagnosing pancreatic and extrapancreatic involvement in autoimmune pancreatitis. Clin Gastroenterol Hepatol 2007; 5:1229-34. [PMID 17702660] https://doi.org/10.1016/j.cgh.2007.04.023
14. Chang MC, Chang YT, Wei SC, Kuo CH, Liang PC, Wong JM. Autoimmune pancreatitis associated with high prevalence of gastric ulcer independent of Helicobacter pylori infection status. Pancreas 2009; 38:442-6. [PMID 19276869] https://doi.org/10.1097/MPA.0b013e31819b5f3c
15. Kamisawa T, Egawa N, Nakajima H, Tsuruta K, Okamoto A, Hayashi Y, Funata N. Gastrointestinal findings in patients with autoimmune pancreatitis. Endoscopy 2005; 37:1127-30. [PMID: 16281144] https://doi.org/10.1055/s-2005-870369
16. Kaji R, Okabe Y, Ishida Y, Takedatsu H, Kawahara A, Aino H, et al. Autoimmune pancreatitis presenting with IgG4-positive multiple gastric polyps. Gastrointest Endosc 2010; 71:420-2. [PMID: 19846081] https://doi.org/10.1016/j.gie.2009.07.023
17. Kubota K. et al. Clinical significance of swollen duodenal papilla in autoimmune pancreatitis. Pancreas. 2007 Nov;35(4):e51-60. https://doi.org/10.1097/mpa.0b013e31812575b4
18. Crosara S. et al. Autoimmune pancreatitis: Multimodality non-invasive imaging diagnosis World J Gastroenterol. 2014 Dec 7; 20(45): 16881-16890. https://doi.org/10.3748/wjg.v20.i45.16881
19. Bansal A. et al. Gastrointestinal complications in acute and chronic pancreatitis JGH Open. 2019 Dec; 3(6): 450-455. https://doi.org/10.1002/jgh3.12185
20. Ramsey ML, Conwell DL, Hart PA. Complications of chronic pancreatitis. Dig. Dis. Sci. 2017; 62: 1745-50. https://doi.org/10.1007/s10620-017-4518-x
21. Oza VM, Skeans JM, Muscarella P et al Groove pancreatitis, a masquerading yet distinct clinicopathological entity: analysis of risk factors and differentiation. Pancreas. 2015; 44: 901-8. https://doi.org/10.1097/MPA.0000000000000351
22. Ferreira A., Ramalho M., Herédia V., R. de Campos, P. Marques Groove pancreatitis: a case report and review of the literature. J Radiol Case Rep. 2010; 4(11): 9-17. https://doi.org/10.3941/jrcr.v4i11.588
23. Howes, N. et al. Clinical and genetic characteristics of hereditary pancreatitis in Europe. Clin. Gastroenterol. Hepatol. 2, 252-261 (2004). https://doi.org/10.1016/S1542-3565(04)00013-8
24. Chen, Xin; Yang, Mo; Wang, Bangmao. A Case of Acute Hypertrophic Gastritis With Pancreatitis and Allergic Purpura.American Journal of Gastroenterology: October 2014 - Volume 109 - Issue - p S44-S45 https://doi.org/10.14309/00000434-201410002-00142
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