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Celiac sprue and macroamylasemia: potential clinical and pathophysiological implications. Case study
P Rajvanshi1, J R Chowdhury, S Gupta
1Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Journal of Clinical Gastroenterology
|June 1, 1995
Summary
Macroamylasemia, often mistaken for pancreatitis, can occur with celiac sprue. Gluten restriction alone stabilized this patient, suggesting a link needing further research.
Area of Science:
- Gastroenterology
- Clinical Biochemistry
Background:
- Celiac sprue is an autoimmune disorder triggered by gluten ingestion.
- Macroamylasemia is a condition characterized by high levels of amylase in the blood due to a complex formed between amylase and immunoglobulins.
Observation:
- A patient with celiac sprue presented with abdominal pain, initially attributed to acute pancreatitis.
- Diagnostic workup revealed hyperamylasemia and choledocholithiasis, further supporting the pancreatitis diagnosis.
Findings:
- The cause of hyperamylasemia was identified as macroamylasemia, associated with elevated serum immunoglobulin A.
- The patient remained clinically stable for four years solely with gluten-free dietary intervention.
Implications:
- This case highlights the importance of considering macroamylasemia in patients with celiac sprue and unexplained hyperamylasemia.
- Further research is warranted to explore the potential association between celiac sprue, other malabsorptive conditions, and macroamylasemia.