Exocrine pancreatic function is preserved in systemic sclerosis

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Exocrine pancreatic function is preserved in systemic sclerosis. / Bozovic, Gracijela; Pullerits, Rille; Ståhl, Arne; Ydström, Kristina; Wenger, Daniel; Marsal, Jan; Thulin, Pontus; Andréasson, Kristofer.

In: Arthritis Research & Therapy, Vol. 21, No. 1, 12.02.2019.

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Bozovic, Gracijela ; Pullerits, Rille ; Ståhl, Arne ; Ydström, Kristina ; Wenger, Daniel ; Marsal, Jan ; Thulin, Pontus ; Andréasson, Kristofer. / Exocrine pancreatic function is preserved in systemic sclerosis. In: Arthritis Research & Therapy. 2019 ; Vol. 21, No. 1.

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TY - JOUR

T1 - Exocrine pancreatic function is preserved in systemic sclerosis

AU - Bozovic, Gracijela

AU - Pullerits, Rille

AU - Ståhl, Arne

AU - Ydström, Kristina

AU - Wenger, Daniel

AU - Marsal, Jan

AU - Thulin, Pontus

AU - Andréasson, Kristofer

PY - 2019/2/12

Y1 - 2019/2/12

N2 - BACKGROUND: Systemic sclerosis (SSc) has been suggested to cause exocrine pancreatic dysfunction. However, a case-control-based autopsy study failed to associate systemic sclerosis with any pancreatic histopathology. The primary objective of this study was to examine the exocrine pancreatic function in consecutive SSc patients in relation to an age- and sex-matched control group. A secondary objective was to relate exocrine pancreatic function to radiological, laboratory, and clinical SSc characteristics. METHODS: One hundred twelve consecutive patients fulfilling the 2013 American Congress of Rheumatology/European League Against Rheumatism criteria for SSc and 52 control subjects were matched for sex and age. Exocrine pancreatic function was assessed by ELISA-based measurement of fecal elastase, and levels ≤ 200 μg/g were considered pathological, i.e., representing exocrine pancreatic insufficiency. Patients were characterized regarding SSc manifestations including gastrointestinal and hepatobiliary function, by use of laboratory and clinical examinations. Pancreas parenchyma characteristics were evaluated by high-resolution computer tomography (HRCT). RESULTS: A similar proportion of subjects exhibited pathological levels of fecal elastase among SSc patients (6/112; 5.4%) and control subjects (3/52; 5.8%). Patients with fecal elastase ≤ 200 μg/g did not differ from other SSc patients with respect to laboratory and clinical characteristics, including malnutrition. SSc subjects with low levels of fecal elastase displayed significantly lower pancreas attenuation on HRCT examinations compared to the control subjects. CONCLUSIONS: In this study encompassing 112 consecutive SSc patients and 52 matched control subjects, we were unable to associate systemic sclerosis with clinically significant exocrine pancreatic dysfunction.

AB - BACKGROUND: Systemic sclerosis (SSc) has been suggested to cause exocrine pancreatic dysfunction. However, a case-control-based autopsy study failed to associate systemic sclerosis with any pancreatic histopathology. The primary objective of this study was to examine the exocrine pancreatic function in consecutive SSc patients in relation to an age- and sex-matched control group. A secondary objective was to relate exocrine pancreatic function to radiological, laboratory, and clinical SSc characteristics. METHODS: One hundred twelve consecutive patients fulfilling the 2013 American Congress of Rheumatology/European League Against Rheumatism criteria for SSc and 52 control subjects were matched for sex and age. Exocrine pancreatic function was assessed by ELISA-based measurement of fecal elastase, and levels ≤ 200 μg/g were considered pathological, i.e., representing exocrine pancreatic insufficiency. Patients were characterized regarding SSc manifestations including gastrointestinal and hepatobiliary function, by use of laboratory and clinical examinations. Pancreas parenchyma characteristics were evaluated by high-resolution computer tomography (HRCT). RESULTS: A similar proportion of subjects exhibited pathological levels of fecal elastase among SSc patients (6/112; 5.4%) and control subjects (3/52; 5.8%). Patients with fecal elastase ≤ 200 μg/g did not differ from other SSc patients with respect to laboratory and clinical characteristics, including malnutrition. SSc subjects with low levels of fecal elastase displayed significantly lower pancreas attenuation on HRCT examinations compared to the control subjects. CONCLUSIONS: In this study encompassing 112 consecutive SSc patients and 52 matched control subjects, we were unable to associate systemic sclerosis with clinically significant exocrine pancreatic dysfunction.

KW - Fecal elastase

KW - Malnutrition

KW - Pancreas

KW - Systemic sclerosis

U2 - 10.1186/s13075-019-1840-z

DO - 10.1186/s13075-019-1840-z

M3 - Article

VL - 21

JO - Arthritis Research & Therapy

T2 - Arthritis Research & Therapy

JF - Arthritis Research & Therapy

SN - 1478-6354

IS - 1

ER -