Transient exocrine pancreatic insufficiency as a possible complication of an enterovirus infection

Biervliet, S. Van; Waele, Kathleen De; Winckel, Myriam Van; Robberecht, Eddy

doi:10.1007/s00431-003-1315-7

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…Low FE1 levels were reported in similar scenarios of diffuse small bowel injury from enteric pathogens (23) and many enteropathies (24,25). Transient EPI, as a clinical diagnosis, was reported following enterovirus infections in the pediatric population (26).…”

Section: Discussionmentioning

confidence: 84%

Transient Exocrine Pancreatic Insufficiency: First Report of an Unrecognized Complication of Cytoreductive Surgery and HIPEC

Naffouje

Salti

2018

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Section: Discussionmentioning

confidence: 84%

Transient Exocrine Pancreatic Insufficiency: First Report of an Unrecognized Complication of Cytoreductive Surgery and HIPEC

Naffouje

Salti

2018

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“…The concomitant findings of a positive CVB4 IgG titer and persistently low levels of pancreatic enzymes provide stronger evidence of the infection timeline. Enteroviruses, including CVB4, have been established to cause transient exocrine pancreatic insufficiency for longer than 1.5 months [ 12 ]. In this patient, the first laboratory evidence of pancreatic insufficiency was documented at the onset of pleurodynia, providing strong evidence of active CVB4 ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Case report: chronic acalculous cholecystitis preceded by Coxsackievirus B4 infection

Fewel

Weiß

Harrington

2022

Journal of Surgical Case Reports

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A 41-year-old female presented with an 8-month history of right upper quadrant pain, exacerbated by ingestion of saturated fats. The patient was positive for antibodies to Coxsackievirus serotype B4, established by an investigation incited by an acute episode of pleurodynia 8 months before the current presentation. Imaging studies including a hepatobiliary iminodiacetic acid scan showed no gallbladder structural or functional abnormalities. Laboratory studies indicated pancreatic enzyme insufficiency associated with below-normal lipase and amylase levels. Patient symptomology was consistent with cholecystitis with positive Murphy’s sign, so cholecystectomy was recommended. Post-surgery pathological report confirmed chronic acalculous cholecystitis. Patient demonstrated full recovery, indicated by return of normal pancreatic enzymes levels and resolution of abdominal pain.

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“…Although pancreatic insufficiency is usually described as a consequence of chronic pancreatitis, cystic fibrosis, and Shwachman‐Diamond disease (1,2,4), the pancreatic insufficiency in our case series could not be attributed to any of these causes. Van Biervliet et al (8) reported a case of a 9‐year‐old boy who presented with fever, abdominal pain, diarrhea, and vomiting, all symptoms resolved but the diarrhea persisted for a month accompanied by an 8% weight loss. Broad investigation revealed FE1 level of <15 mg/g stool and steatorrhea.…”

Section: Discussionmentioning

confidence: 99%

“…only 1 case report that described severe pancreatic insufficiency after gastrointestinal infection with enterovirus (8).…”

Section: What Is Newmentioning

confidence: 99%

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Transient Exocrine Pancreatic Insufficiency in Children

Garah

Rosen

Shaoul

2019

J. pediatr. gastroenterol. nutr.

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Objectives: Pancreatic insufficiency in children is usually associated with diseases such as cystic fibrosis, Shwachman-Diamond syndrome, or chronic pancreatitis. Fecal elastase-1 is a reliable laboratory test for the diagnosis of exocrine pancreatic insufficiency (EPI). Transient pancreatic insufficiency has been rarely described and data on this entity are lacking in the medical literature. In this retrospective study we report 17 cases of transient pancreatic insufficiency presented mainly with failure to thrive and/or diarrhea. Methods: We followed 43 children (age range 1 month–18 years) with low fecal elastase-1 in our institution between the years 2009 and 2017. We followed growth and laboratory results (particularly, complete blood count, albumin, transaminases, celiac serology, sweat test, and fat-soluble vitamins). Elastase levels <200 mg/g were considered as pancreatic insufficiency. Results: Twenty-six were excluded due to missing data, a comorbidity or being syndromatic. Enrolled children (17) were all otherwise healthy. The median age at diagnosis was 3 years (range 0.2–15 years), 11 girls and 6 boys. Their main presenting symptoms were failure to thrive and/or diarrhea. Median fecal elastase-1 levels were 71 mg/g (range 18–160). Median time for normalization was 6 months (range 1–48 months). Abdominal sonography, celiac serology, and sweat test were normal for all patients. Most patients were treated with pancreatic enzymes until resolution. Conclusions: Transient EPI without clear etiology should be in the differential diagnosis of EPI after ruling out known etiologies. The resolving course pattern may be attributed to an unidentified infectious agent. Further studies to assess the etiology are mandated.

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Transient exocrine pancreatic insufficiency as a possible complication of an enterovirus infection

Abstract: This is the first description of a child with a transient but severe exocrine pancreatic insufficiency probably induced by an ordinary enterovirus infection

Cited by 5 publications

References 9 publications

Transient Exocrine Pancreatic Insufficiency: First Report of an Unrecognized Complication of Cytoreductive Surgery and HIPEC

Transient Exocrine Pancreatic Insufficiency: First Report of an Unrecognized Complication of Cytoreductive Surgery and HIPEC

Case report: chronic acalculous cholecystitis preceded by Coxsackievirus B4 infection

Transient Exocrine Pancreatic Insufficiency in Children

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