DOI: http://dx.doi.org/10.18203/2349-3933.ijam20195256

Non-alcoholic chronic calcific pancreatitis in a patient of celiac disease: a rare presentation

Saurabh Gupta, Poonam Gupta, Rajesh Chetiwal, Priyank Rastogi, Amit Kumar, Rajat Kumar

Abstract


Celiac disease is a common malabsorptive disorder in the Indian subcontinent and autoimmune dysfunction of thyroid and pancreas is frequently encountered along with. Chronic Calcific pancreatitis is a unique entity commonly seen in alcoholics but very rare in a patient of celiac disease. This case report includes the interesting constellation of calcific pancreatitis with celiac disease in a young adult male patient known case of insulin dependent diabetes and hypothyroidism. We believe it to be the only case report from north India. A 32 year old Indian male patient known case of Diabetes and hypothyroidism presented with features of malabsorption and was diagnosed with Celiac disease and calcific pancreatitis on imaging. The symptoms and insulin requirement also improved with the treatment of Celiac disease. Although a common involvement of pancreas in celiac disease, calcific pancreatitis is a rare finding and improvement of both the insulin requirement and malabsorptive symptoms with the treatment of celiac disease and pancreatitis vice-a-versa.


Keywords


Calcific pancreatitis, Celiac disease, Diabetes mellitus

Full Text:

PDF

References


Makharia GK, Verma AK, Amarchand R, Bhatnagar S, Das P, Goswami A, Bhatia V, Ahuja V, Datta Gupta S, Anand K. Prevalence of celiac disease in the northern part of India: a community based study. J Gastroenterol Hepatol. 2011 May;26(5):894-900.

Rana SS, Dambalkar A, Chhabra P, Sharma R, Nada R, Sharma V, et al. Is pancreatic exocrine insufficiency in celiac disease related to structural alterations in pancreatic parenchyma?. Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology. 2016 Jul;29(3):363.

Patel RS, Johlin Jr FC, Murray JA. Celiac disease and recurrent pancreatitis. Gastrointestinal Endoscopy. 1999 Dec 1;50(6):823-7.

Sadr-Azodi O, Sanders DS, Murray JA, Ludvigsson JF. Patients with celiac disease have an increased risk for pancreatitis. Clin Gastroenterol Hepatol. 2012;10:1136-42.

Regan PT, DiMagno EP. Exocrine pancreatic insufficiency in celiac sprue: a cause of treatment failure. Gastroenterol. 1980;78:484-7.

Pitchumoni CS. Pancreas in primary malnutrition disorders. Am J Clin Nutr. 1973;26:374-9.

Freeman HJ, Whittaker JS. Nonalcoholic chronic pancreatitis with pancreatic calcifi cation: presenting manifestation of occult celiac disease. Can J Gastroenterol. 1994;8:319-22.

OiMagno EP, Go VLW, Summerskill WHJ. Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl Med. 1973;288:813-5.

Freeman HJ. Celiac-associated pancreatic disease. Ann Gastroenterol. 2016;29(3):241-2.

Carroccio A, Iacono G, Montalto G, Cavataio F, Di Marco C, Balsamo V, et al. Exocrine pancreatic function in children with coeliac disease before and after a gluten free diet. Gut. 1991 Jul 1;32(7):796-9.

OiMagno EP, Go VLW, ummer·kill WHJ. lmpaired cholecystokinin pancreozymin secretion, intraluminal dilution, and maldigestion of fat in sprue. Gastroenterol. l 972;63:25-32.

Buchan AM, Grant S, Brown JC, Freeman HJ. A quantitative study of enteric endocrine cells in celiac sprue. J Pediatr Gastroenterol Nutr. 1984;3:665-71.

Weinstein LD, Herskovic T. Rectal seepage of oil in a patient with celiac disease and secondary pancreatic insufficiency. Am J Dig Dis. 1968;13:762-5.

Freeman HJ, Kim YS, Sleisenger MH. Protein digestion and absorption in man. Normal mechanisms and protein-energy malnutrition. Am J Med. 1979;67:1030-6.

Pitchumoni CS, Thomas E, Balthazar E, Sherling B. Chronic calcific pancreatitis in association with celiac dlisease. Am J Ga Troenterol. 1977;68:358-61.

Nanda R, Anand BS. Celiac disease and tropical calcific pancreatitis. Am J Gastroenterol. 1976;66:117-39.