Biological explorations of pancreatic diseases & panc cancer

Front

To begin with, what is the suspected diagnosis of Jean in our case? Options: Acute pancreatitis, Pancreatic cancer, Liver failure, Chronic pancreatitis

Back

Chronic pancreatitis

Front

What is the main reason that led to the suspicion of chronic pancreatitis in Jean's case?

Back

alcohol

Answer explanation

Chronic alcoholism is the main cause of chronic pancreatitis (mostly men, 40-45yo = exactly Jean's case!)

Other causes: Autoimmune, Genetic, Idiopathic, Hypercalcemia,...

Front

What is dosed in case of acute pancreatitis?

Back

lipase levels

Front

True or False? Lipase level measurement is only used to diagnose acute pancreatitis when suspected and is not indicated in other cases.

Back

True

Front

Can pancreatic diseases lead to diabetes?

Back

YES

Front

What is the main way to screen diabetes in pancreatic diseases? Options: Random Blood Glucose, HbA1c (Glycated Hemoglobin), Oral Glucose Tolerance Test (OGTT), Fasting Blood Glucose (FBG)

Back

Fasting Blood Glucose (FBG)

Front

What is the gold standard for assessing the exocrine function of the pancreas? Hint: it is an enzyme

Back

faecal elastase l

Front

Do you know why Elastase-1 is a very useful enzyme to measure to assess exocrine pancreatic insufficiency (EPI)

Back

Yes, it is a useful enzyme for assessing EPI.

Answer explanation

• - a stable pancreatic enzyme that is not digested during its transit through the intestine and eliminated intact in the stool = reliable marker for the pancreatic function unlike amylase or lipase

• - Specific to the pancreas: produced only by pancreatic acinar cells
  - Concentration remains stable in stool: making it easy to measure non-invasively.
  

• ->>> Low levels indicate pancreatic insufficiency: used to diagnose chronic pancreatitis, cystic fibrosis, or pancreatic cancer.

Front

Below what diagnostic threshold of Fecal Elastase-1 (in µg/g) does exocrine pancreatic insufficiency become certain?

Back

100

Answer explanation

Above 200 μg per gram of stool, there is no exocrine pancreatic insufficiency (when the pancreas functions normally, it releases sufficient digestive enzymes)

Below 100 μg per gram of stool, there is exocrine pancreatic insufficiency.

Between these two values, the test is considered uninterpretable.

Front

Let's move on to pancreatic cancer, and more specifically, pancreatic adenocarcinoma !!

Back

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