Pancreatitis, chronic case study

Of 62 initially autoantibody-negative patients treated with interferon alfa for chronic hepatitis C for a mean of 8 months, three developed antibodies to 21b-hydroxylase, a sensitive assay of adrenocortical autoimmunity (528). However, there were no cases of Addison s disease or subclinical adrenal insufficiency. This study suggested that the adrenal cortex is another potential target organ of autoimmune effects of interferon alfa, along with thyroid and pancreatic islet cells. 

In patients with chronic hepatic B or C the respective prevalences of pancreatic autoantibodies increased from 2% and 3% at baseline to 5% and 7% after interferon (544). In all, 31 published cases of type 1 diabetes mellitus attributed to interferon alfa treatment were detailed, mostly in patients with hepatitis C. Irreversible diabetes required permanent insulin treatment in all but eight cases. At least one marker of pancreatic autoimmunity was positive in nine of 18 patients before treatment, and in 23 of 30 patients at the onset of diabetes. In accordance with these results and the likelihood of a genetic predisposition, the authors recommended screening for islet cell and glutamic acid decarboxylase autoantibodies before and during interferon alfa treatment. However, owing to the low number of reported cases and the paucity of studies that have examined the relation between pancreatic autoimmunity and the occurrence of diabetes, further research on the predictive potential of such a systematic investigation is warranted. 

Female rats are also more susceptible than males to such organophosphorus insecticides as azinphosme-thyl and parathion. Castration or estrogen treatment of the male reverses this difference. The male rat is far more susceptible to carcinoma than the female as shown in the following examples Males are more susceptible to the induction of pancreatic tumors by azaserine, colonic carcinoma by dime-thylhydrazine, intestinal tumors by dimethylnitrosa-mine, renal tumors by decalin, and liver cirrhosis by AAF. In the case of hydroquinone, which is present in photographic material, acute exposure produced renal toxicity in the female but in a chronic 2 year study, the male and not the female was found to have tubular degeneration and adenoma. 

Chronic pancreatitis has long been thought to be mainly associated with immoderate alcohol consumption, tobacco smoke, and obesity, diets high in animal protein and fat, as well as antioxidant deficiencies. Diets high in processed or red meat, diets low in fruits and vegetables, phytochemicals such as lycopene and flavonols, have been proposed and refuted as risk or protective factors in different trials [131]. In a case-control study of 462 cases and 4,721 controls, there was a significant inverse association between lycopene intake and pancreatic cancer, after... 

Pancreas Case reports and pharmacoepidemiological studies have provided evidence that statins may cause pancreatitis. However, data from the SHARP study, a placebo-controlled study of the effects of a combination of simvastatin and ezetimibe on cardiovascular events in patients with chronic kidney disease, showed a reduction in the number of cases of pancreatitis [75] [40 -]. Recent prospective cohort study with 1062 subjects of whom 92 were taking statins found severe pancreatitis was more common in the statin nonuser than statin user. Pancreatitis-related mortality was higher in the statin nonuser, and among patients who developed severe acute pancreatitis, statin users showed lower Ranson s and APACHE II scores and lower maximal CRP, suggesting that prior statin treatment reduced morbidity and mortality in acute pancreatitis [76]. 

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