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Exocrine pancreatic function in patients with progressive systemic sclerosis.

L Hendel¹, H Worning

¹Dept. of Dermatology, University of Copenhagen, Rigshospitalet, Denmark.

Scandinavian Journal of Gastroenterology

|May 1, 1989

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Progressive systemic sclerosis can affect exocrine pancreatic function, with about one-third of patients showing reduced function. However, only a few cases demonstrated clinically significant pancreatic insufficiency.

Area of Science:

Gastroenterology
Internal Medicine
Rheumatology

Background:

Progressive systemic sclerosis (PSS) is a multisystem autoimmune disease.
Gastrointestinal (GI) involvement is common in PSS, potentially affecting pancreatic function.
Exocrine pancreatic insufficiency can lead to malabsorption and nutritional deficiencies.

Purpose of the Study:

To investigate exocrine pancreatic function in patients with PSS.
To correlate pancreatic function with other GI manifestations of PSS.
To determine the clinical significance of exocrine pancreatic dysfunction in PSS.

Main Methods:

Meal test (Lundh test) and secretin-cholecystokinin test were used to assess exocrine pancreatic function.
Esophageal manometry and small bowel roentgenography evaluated GI involvement.

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Fecal fat excretion, D-xylose absorption, and duodenal biopsy assessed small intestinal function and bacterial overgrowth.

Main Results:

One-third of patients with PSS exhibited reduced exocrine pancreatic function.
Only four patients had pancreatic function reduction of potential clinical importance.
Meal test results correlated well with secretin-cholecystokinin test findings.
Endogenous pancreatic stimulation capacity was generally preserved.

Conclusions:

Exocrine pancreatic dysfunction occurs in a subset of PSS patients.
The clinical significance of this dysfunction appears limited in most cases.
Standard tests effectively evaluate pancreatic exocrine function in PSS patients.