Lipodystrophy, pancreatitis, and eosinophilia.

Smith, Peter; Morgans, M.E.; Clark, C. G.; Lennard‐Jones, J. E.; Gunnlaugsson, Ólafur; Jonasson, TóMASÁ

doi:10.1136/gut.16.3.230

Cited by 18 publications

(16 citation statements)

References 10 publications

(9 reference statements)

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“…In the past, only a few cases with a similar course have been reported [6,7,8,9,10,11,12,13]. A food allergen connected to the occurrence of EGE was identified in the case we studied.…”

Section: Introductionmentioning

confidence: 68%

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Suzuki¹,

Homma²,

Kurokawa³

et al. 2012

Int Arch Allergy Immunol

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Eosinophilic gastroenteritis (EGE) is characterized by eosinophilic infiltration of the digestive organs, most commonly of the stomach and the duodenum. Symptoms of EGE are nonspecific and include nausea, vomiting, abdominal pain, dyspepsia, malabsorption, ascites and weight loss. The various symptoms of EGE depend on its location and the depth of gastrointestinal eosinophil infiltration. We report a case presenting with acute pancreatitis caused by a milk allergy. The patient’s symptoms rapidly improved after treatment with corticosteroids, and he remained symptom-free for more than 20 months by the elimination of cow’s milk from his diet. Serum titers of pancreatic enzymes and total bilirubin simultaneously recovered and blood eosinophil counts normalized. The causative allergens of EGE are too various to detect; however, allergologic exams revealed that a cow’s milk allergy had provoked EGE in our case. Adult-onset cow’s milk allergies are rare; when seen, however, they may present severe complications such as anaphylaxis, gastroenteritis and pancreatitis. When unaccountable gastrointestinal symptoms are observed, EGE caused by food allergies should be included in the differential diagnosis.

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“…In the past, only a few cases with a similar course have been reported [6,7,8,9,10,11,12,13]. A food allergen connected to the occurrence of EGE was identified in the case we studied.…”

Section: Introductionmentioning

confidence: 68%

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Suzuki¹,

Homma²,

Kurokawa³

et al. 2012

Int Arch Allergy Immunol

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“…-Corticosteroids Baar and Wolff, 1957;Riemenschneider, Wilson and Vernier, 1968 -L-asparaginase Weetman and Baehner, 1974 -Chlorthiazide Shanklin, 1962 -Scorpion venom Bartholomew, 1970 Hyperlipoproteinaemia (types I and V) -Fredrickson and Levy, 1972 Hypercalcaemia -Daum, Rosen and Boley, 1973 Structural abnormalities of the pancreatic ducts - Hendren et al, 1965 Gall stones - Hendren et al, 1965 Ascaris lumbricoides infection - Stein, 1963 Choledocal cyst -Karjoo et al, 1973 Cystic fibrosis -Shwachman, Lebenthal and Khan, 1975 Diabetes mellitus -Malone, 1974 Malnutrition -Collins, 1958 Syndrome of pancreatitis and partial lipodystrophy -Smith et al, 1975 Alcohol - Schmidt et nl., 1964 children with idiopathic acute pancreatitis probably represent one end of the age spectrum of the disease as it occurs in adults.…”

Section: Discussionmentioning

confidence: 99%

Pancreatitis in childhood

Sibert

1979

Postgraduate Medical Journal

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Summary Follow-up of 25 cases of pancreatitis in childhood ascertained from the Hospital Activity Analysis in Newcastle and Wales showed that the majority of the children thrived after their illness. Only one child died. Only 2 children developed diabetes mellitus and 3 had significant malabsorption. There were 13 idiopathic cases (9 acute, 4 chronic relapsing), 3 of which were obese girls of pubertal age. It is speculated that obesity, puberty and female sex together may predispose to acute pancreatitis.

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“…In many patients, the infraumbilical region of the anterior abdomen was also spared (Patients 10, 13, and 33). Only rarely, fat loss affected the inguinal region and thighs 120,137,141,159,165,179 (Patient 11) (see Figure 2). A sharp line of demarcation was seen occasionally between the lipodystrophic and unaffected areas 49,77,165,179 .…”

Section: Demographic and Clinical Featuresmentioning

confidence: 95%

Clinical Features and Metabolic and Autoimmune Derangements in Acquired Partial Lipodystrophy

Misra

Peethambaram

Garg³

2004

Medicine

249

252

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We describe clinical features, body fat distribution, and prevalence of metabolic abnormalities in 35 patients with acquired partial lipodystrophy (APL) seen by us over 8 years, and also review 220 cases of APL described in the literature. Based on the review and our experience, we propose that the essential diagnostic criterion for APL is the gradual onset of bilaterally symmetrical loss of subcutaneous fat from the face, neck, upper extremities, thorax, and abdomen, in the "cephalocaudal" sequence, sparing the lower extremities. Analysis of the pooled data revealed that female patients were affected approximately 4 times more often than males. The median age of the onset of lipodystrophy was 7 years. Several autoimmune diseases, in particular systemic lupus erythematosus and dermatomyositis, were associated with APL. The prevalence rates of diabetes mellitus and impaired glucose tolerance were 6.7% and 8.9%, respectively. Approximately 83% of APL patients had low complement (C) 3 levels and the presence of polyclonal immunoglobulin C3 nephritic factor. Twenty-two percent of patients developed membranoproliferative glomerulonephritis (MPGN) after a median of approximately 8 years following the onset of lipodystrophy. Compared with patients without renal disease, those with MPGN had earlier age of onset of lipodystrophy (12.6 +/- 10.3 yr vs 7.7 +/- 4.4 yr, respectively; p < 0.001) and a higher prevalence of C3 hypocomplementemia (78% vs 95%, respectively; p = 0.02). The pathogenesis of fat loss and MPGN in patients with APL remains unclear, but activation of an alternate complement pathway has been implicated. Treating the cosmetic disfigurement by surgical procedures has yielded inconsistent results. The use of thiazolidinediones to treat fat loss in patients with APL remains anecdotal. Prognosis is mainly determined by renal insufficiency due to MPGN.

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Lipodystrophy, pancreatitis, and eosinophilia.

Cited by 18 publications

References 10 publications

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Pancreatitis in childhood

Clinical Features and Metabolic and Autoimmune Derangements in Acquired Partial Lipodystrophy

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