Pancreatic function tests in tropical sprue is pancreas involved?

Area of Science:

• Gastroenterology
• Malabsorption Syndromes
• Pancreatic Physiology

Background:

• Tropical sprue is a malabsorption syndrome prevalent in tropical regions.
• Previous studies suggested potential pancreatic involvement in tropical sprue based on indirect stimulation tests.
• Understanding the role of the exocrine pancreas is crucial for diagnosing and managing malabsorption.

Purpose of the Study:

• To directly assess exocrine pancreatic function in patients diagnosed with tropical sprue.
• To determine if pancreatic hyposecretion contributes to the malabsorption observed in tropical sprue.
• To clarify the primary etiological factors in tropical sprue.

Main Methods:

• Study included 15 patients diagnosed with tropical sprue based on established malabsorption criteria.
• Exocrine pancreatic secretion was directly stimulated using exogenous secretin (Boots) at a dose of 1 clinical unit/kg.
• Pancreatic juice volume output and bicarbonate concentration were measured and compared to normal values.

Main Results:

• 12 out of 15 patients exhibited normal exocrine pancreatic function.
• Two patients showed marginally low pancreatic volume output (1.6 ml/kg/hr).
• One patient had normal volume but reduced bicarbonate concentration (61.6 mEq/L), with no patient showing abnormalities in both parameters.

Conclusions:

• Direct stimulation with secretin revealed normal pancreatic function in most tropical sprue patients.
• The findings suggest that the exocrine pancreas is not primarily affected in tropical sprue.
• The primary cause of malabsorption in tropical sprue likely lies outside of pancreatic exocrine function.