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Elevated Lipase during Initial Presentation of Ulcerative Colitis in a Pediatric Patient: Do We Check for It

View Article: PubMed Central - PubMed

ABSTRACT

There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines. Checking pancreatic enzymes during initial presentation of IBD may, therefore, be important to determine if pancreatic involvement has resulted from the inflammation in IBD or as an adverse effect of therapy. If unchecked, recurrent subclinical pancreatitis may be masked by IBD symptoms and missed prior to starting IBD therapy. This may result in chronic pancreatic insufficiency as reported in 50% of adults with IBD. Early detection of elevated pancreatic enzymes in IBD may help direct the management strategy, as treatment of the underlying inflammation in IBD may be the most important management for resolution of pancreatitis instead of cessation of therapy for fear of iatrogenic medication-induced pancreatitis.

No MeSH data available.


Related in: MedlinePlus

Lipase trend during induction and remission of ulcerative colitis.
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Figure 2: Lipase trend during induction and remission of ulcerative colitis.

Mentions: After 3 months of treatment of her ulcerative colitis, her lipase began to show a downward trend approaching normal values at 73 u/l (fig 2). This correlated with clinical improvement of her ulcerative colitis, as she had normal regular bowel movements with no further bleeding or abdominal pain. Her fecal calprotectin also correlated with clinical remission and normalized to 23.9 µg/g.


Elevated Lipase during Initial Presentation of Ulcerative Colitis in a Pediatric Patient: Do We Check for It
Lipase trend during induction and remission of ulcerative colitis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121551&req=5

Figure 2: Lipase trend during induction and remission of ulcerative colitis.
Mentions: After 3 months of treatment of her ulcerative colitis, her lipase began to show a downward trend approaching normal values at 73 u/l (fig 2). This correlated with clinical improvement of her ulcerative colitis, as she had normal regular bowel movements with no further bleeding or abdominal pain. Her fecal calprotectin also correlated with clinical remission and normalized to 23.9 µg/g.

View Article: PubMed Central - PubMed

ABSTRACT

There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines. Checking pancreatic enzymes during initial presentation of IBD may, therefore, be important to determine if pancreatic involvement has resulted from the inflammation in IBD or as an adverse effect of therapy. If unchecked, recurrent subclinical pancreatitis may be masked by IBD symptoms and missed prior to starting IBD therapy. This may result in chronic pancreatic insufficiency as reported in 50% of adults with IBD. Early detection of elevated pancreatic enzymes in IBD may help direct the management strategy, as treatment of the underlying inflammation in IBD may be the most important management for resolution of pancreatitis instead of cessation of therapy for fear of iatrogenic medication-induced pancreatitis.

No MeSH data available.


Related in: MedlinePlus