Plasma glucagon in acute and chronic pancreatitis

Buch, Annette; Holst, Jens J.; Schmidt, Arne; Buch, J

doi:10.1007/bf01561524

Cited by 5 publications

(3 citation statements)

References 23 publications

(31 reference statements)

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“…Other reports of this etiology either fail to measure glucagon or report low glucagon levels as would be expected in chronic pancreatitis. 6,16–18 Therefore, our patient's elevated glucagon level may have contributed to her NME presentation. In patients with normal glucagon levels, it is speculated that NME skin findings are mediated by enteroglucagon rather than glucagon, a substance that is produced by the crypt cells of the small intestine in the malabsorptive state.…”

Section: Answermentioning

confidence: 87%

Ulcerative Lesions and Diarrhea: Answer

Beuerlein

Bowers

Savas

et al. 2022

The American Journal of Dermatopathology

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Section: Answermentioning

confidence: 87%

Ulcerative Lesions and Diarrhea: Answer

Beuerlein

Bowers

Savas

et al. 2022

The American Journal of Dermatopathology

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“…We did however identify documented associations between elevated circulating glucagon concentrations and a range of medical conditions. These include diabetes mellitus ( 46 – 48 ) [including gestational diabetes ( 49 )], acute and chronic pancreatitis ( 50 , 51 ), chronic kidney disease (including that associated with type 2 diabetes mellitus) ( 52 , 53 ) and liver cirrhosis ( 54 – 56 ). Small studies have also suggested potential associations with hyperthyroidism ( 57 ) and the second trimester of pregnancy ( 57 ), although these findings have not yet been independently verified to the best of our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center

et al. 2020

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IntroductionIn the UK, the fasting plasma concentrations of a panel of gut hormones (comprising vasoactive intestinal peptide (VIP), gastrin, pancreatic polypeptide (PP), glucagon, somatostatin and chromogranin A) are measured to evaluate patients who have or who (due to unexplained and compatible symptoms) are suspected of having neuroendocrine tumors (NETs). False positive elevated hormone concentrations are sometimes found.ObjectiveTo evaluate the frequency and implications of false positive fasting gut hormone results.MethodsRetrospective audit of fasting gut hormone profile results at a large UK university teaching hospital over 12 months.ResultsFasting gut hormone concentrations were measured in 231 patients during 2017. No NETs were found in the 88 patients who had this test performed only to investigate symptoms. 31 false positive gastrin, 8 false positive chromogranin A, two false positive glucagon, three false positive somatostatin, one false positive PP, and one false positive VIP results were found. We extended the audit for glucagon and somatostatin for an additional two years and found seven probable false-positive raised glucagon concentrations and four probable false-positive elevated plasma somatostatin concentrations in total.ConclusionsFalse-positive elevations of plasma gastrin and chromogranin A were common and causes such as proton pump inhibitor use or inadequate fasting accounted for most cases. Elevated plasma concentrations of the other gut hormones were also detected in patients who had no other evidence of NET. Other diagnoses (e.g. cirrhosis and medullary thyroid carcinoma for hypersomatostatinemia and type 2 diabetes mellitus, pancreatitis, liver or renal impairment for hyperglucagonemia) may cause these false positive results.

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“…The glucagon level decreased in both groups after surgery. This seems to be due to the removal of the inflammatory activity in the pancreas which is responsi ble for an elevated glucagon level in acute attacks of chronic pancreatitis [40,41], Glucagon elevates the blood glucose level so that this effect should have a positive influence on the blood glucose level. However, the major difference between the surgical procedures is, in fact, the preservation of the duodenum and this appears to be the crucial factor for intact or unchanged glucose tolerance after duodenum-preserving resection.…”

Section: Discussionmentioning

confidence: 99%

Duodenum-Preserving Resection of the Head of the Pancreas: The Future

Friess¹,

Müller²,

Büchler³

1994

Dig Surg

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In a randomized unicenter clinical study duodenum-preserving pancreatic head resection and pylorus-preserving Whipple operation were prospectively compared in patients with chronic pancreatitis. Preoperatively, 10 days and 6 months postoperatively the patients were investigated with regard to glucose tolerance, pain relief, weight gain, hospital readmission, professional rehabilitation and postoperative complications. In the 6 months’ follow-up, patients who underwent the duodenum-preserving pancreatic head resection had less pain, greater weight gain, a better glucose tolerance and a higher insulin secretion capacity than patients with the pylorus-preserving Whipple resection. The postoperative mortality was zero and the postoperative morbidity was comparable in both groups (duodenum-preserving pancreatic head resection: 3/20 patients (15%), pylorus-preserving Whipple operation 4/20 patients (20%)). Duodenum-preserving pancreatic head resection provides a better postoperative outcome than the pylorus-preserving Whipple resection. Therefore, it should be considered as a new standard operation in patients with chronic pancreatitis and pancreatic head-related complications.

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Plasma glucagon in acute and chronic pancreatitis

Cited by 5 publications

References 23 publications

Ulcerative Lesions and Diarrhea: Answer

Ulcerative Lesions and Diarrhea: Answer

Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center

Duodenum-Preserving Resection of the Head of the Pancreas: The Future

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