Indian J Gastroenterol (May–June 2014) 33(3):231–236 DOI 10.1007/s12664-013-0421-3
ORIGINAL ARTICLE
Clinical profile of early-onset and late-onset idiopathic chronic pancreatitis in South India Gopalakrishna Rajesh & Ambadiyil Balan Veena & Saumya Menon & Vallath Balakrishnan
Received: 6 June 2013 / Accepted: 13 October 2013 / Published online: 14 November 2013 # Indian Society of Gastroenterology 2013
Abstract Background and Aim Idiopathic chronic pancreatitis (ICP) is the most common form of chronic pancreatitis reported in India. There is paucity of literature on the prevalence and profiles of early- and late-onset forms of ICP in India. Material and Methods We compared the profile of early- and late-onset ICP in a patient population attending a tertiary care hospital in South India. Results Pain was the characteristic feature as more than 90 % with both early-onset and late-onset ICP had pain as the most significant symptom. Onset of pain was at age 14.9±7.7 years in early-onset and at 38.1±9.9 in late-onset ICP (p 80 g of alcohol/day for at least 5 years. ICP was diagnosed if preexisting conditions were likely to cause CP (primary hyperparathyroidism, hypertriglyceridemia, hereditary pancreatitis, and other rare causes as well as excess alcohol consumption was ruled out). We compared the profile of early- and late-onset ICP. We also tried to correlate clinical features with the amount of alcohol intake in male patients with early-onset CP. The effect of smoking was also assessed. There were no female patients with alcohol intake. The study was approved by the Institutional Ethics Committee, and written informed consent was obtained from the study subjects. Statistical analysis was performed using SPSS version 11. Statistical significance of the association of each risk factor with diabetes was tested by applying chi-square test. Multivariate stepwise logistic regression analysis was done to identify the significant risk factors, taking into consideration the interassociation among the risk factors and with diabetes. Odds ratios with 95 %
Fig. 1 Flowchart showing patient enrollment
ICP PATIENTS RETROSPECTIVELY ENROLLED. (JANUARY 2004-DECEMBER 2006) (n=185)
LATE ONSET ICP (n=160)
All CP PATIENTS (JANUARY 2004 TO DECEMBER 2010) (n=597 )
ICP PATIENTS (JANUARY 2004-DECEMBER 2010) (n=390) EARLY ONSET ICP (n=230)
ICP PATIENTS PROSPECTIVELY FOLLOWED UP FOR COMPLICATIONS (JANUARY 2007-DECEMBER 2010.). ELASTASE MEASUREMENT DONE. (n=205) MALE (n=118)
FEMALE (n=112)
EARLY ONSET ICP (n=111)
NO ALCOHOL INTAKE (n=55)
SMALL AMOUNT ALCOHOL INTAKE (n=63)
LATE ONSET ICP (n=94)
Indian J Gastroenterol (May–June 2014) 33(3):231–236
233
confidence interval and level of significance were computed both in the univariate and multivariate analysis for the risk factors.
Results There were a total of 597 (175 ACP and 390 ICP) patients with chronic pancreatitis who were seen and followed up in our Pancreas Clinic from January 2004 to December 2010. There were 230 patients with early-onset and 160 patients with late-onset ICP. There were 118 consecutive male patients who had onset of CP before 30 years age. We could retrieve complete records of 185 ICP patients who had been seen in the clinic from January 2004 to December 2006. We prospectively followed up 205 ICP patients for complications and development of pancreatic cancer from January 2007 to December 2010. Fecal elastase 1 measurement was also performed in these patients. There were 111 (54.1 %) patients who had early-onset as compared to 94 (45.9 %) who had late-onset ICP. Table 1 shows the comparison of early-onset and late-onset ICP. Onset of pain was at 14.9±7.7 years in early onset and at 38.1±9.9 in late-onset ICP (p
ORIGINAL ARTICLE
Clinical profile of early-onset and late-onset idiopathic chronic pancreatitis in South India Gopalakrishna Rajesh & Ambadiyil Balan Veena & Saumya Menon & Vallath Balakrishnan
Received: 6 June 2013 / Accepted: 13 October 2013 / Published online: 14 November 2013 # Indian Society of Gastroenterology 2013
Abstract Background and Aim Idiopathic chronic pancreatitis (ICP) is the most common form of chronic pancreatitis reported in India. There is paucity of literature on the prevalence and profiles of early- and late-onset forms of ICP in India. Material and Methods We compared the profile of early- and late-onset ICP in a patient population attending a tertiary care hospital in South India. Results Pain was the characteristic feature as more than 90 % with both early-onset and late-onset ICP had pain as the most significant symptom. Onset of pain was at age 14.9±7.7 years in early-onset and at 38.1±9.9 in late-onset ICP (p 80 g of alcohol/day for at least 5 years. ICP was diagnosed if preexisting conditions were likely to cause CP (primary hyperparathyroidism, hypertriglyceridemia, hereditary pancreatitis, and other rare causes as well as excess alcohol consumption was ruled out). We compared the profile of early- and late-onset ICP. We also tried to correlate clinical features with the amount of alcohol intake in male patients with early-onset CP. The effect of smoking was also assessed. There were no female patients with alcohol intake. The study was approved by the Institutional Ethics Committee, and written informed consent was obtained from the study subjects. Statistical analysis was performed using SPSS version 11. Statistical significance of the association of each risk factor with diabetes was tested by applying chi-square test. Multivariate stepwise logistic regression analysis was done to identify the significant risk factors, taking into consideration the interassociation among the risk factors and with diabetes. Odds ratios with 95 %
Fig. 1 Flowchart showing patient enrollment
ICP PATIENTS RETROSPECTIVELY ENROLLED. (JANUARY 2004-DECEMBER 2006) (n=185)
LATE ONSET ICP (n=160)
All CP PATIENTS (JANUARY 2004 TO DECEMBER 2010) (n=597 )
ICP PATIENTS (JANUARY 2004-DECEMBER 2010) (n=390) EARLY ONSET ICP (n=230)
ICP PATIENTS PROSPECTIVELY FOLLOWED UP FOR COMPLICATIONS (JANUARY 2007-DECEMBER 2010.). ELASTASE MEASUREMENT DONE. (n=205) MALE (n=118)
FEMALE (n=112)
EARLY ONSET ICP (n=111)
NO ALCOHOL INTAKE (n=55)
SMALL AMOUNT ALCOHOL INTAKE (n=63)
LATE ONSET ICP (n=94)
Indian J Gastroenterol (May–June 2014) 33(3):231–236
233
confidence interval and level of significance were computed both in the univariate and multivariate analysis for the risk factors.
Results There were a total of 597 (175 ACP and 390 ICP) patients with chronic pancreatitis who were seen and followed up in our Pancreas Clinic from January 2004 to December 2010. There were 230 patients with early-onset and 160 patients with late-onset ICP. There were 118 consecutive male patients who had onset of CP before 30 years age. We could retrieve complete records of 185 ICP patients who had been seen in the clinic from January 2004 to December 2006. We prospectively followed up 205 ICP patients for complications and development of pancreatic cancer from January 2007 to December 2010. Fecal elastase 1 measurement was also performed in these patients. There were 111 (54.1 %) patients who had early-onset as compared to 94 (45.9 %) who had late-onset ICP. Table 1 shows the comparison of early-onset and late-onset ICP. Onset of pain was at 14.9±7.7 years in early onset and at 38.1±9.9 in late-onset ICP (p
