Document Detail

Alterations in intestinal permeability and endotoxemia in severe acute pancreatitis.
MedLine Citation:
PMID:  22803295     Owner:  NLM     Status:  In-Process    
BACKGROUND: Intestinal permeability increases early in the course of acute pancreatitis and is associated with sepsis and organ failure.
AIM: To evaluate the intestinal permeability (IP) and anti-endotoxin antibodies immunoglobulin G and A (AEA IgG and A) in severe acute pancreatitis (SAP) as compared to healthy controls and determine their significance in relation to various complications of SAP.
METHODS: IP was measured by urinary lactulose/mannitol (LM) excretion ratio and anti-endotoxin antibodies by Endocab ELISA kit at days one and seven of admission (D1 and D7).
RESULTS: Thirty one patients of SAP [mean age (42.0 +/- 15.8) years, APACHE II scores (8.8 +/- 5.4) and CT severity index (6.4 +/- 2.0)] were included in this study. Infected pancreatic necrosis was detected in 13 (42%) patients of whom three died. Six died of persistent organ failure. Median values of LM ratio at D1 and D7 were similar to those in healthy controls. Patients experiencing complications [organ failure (4/9, 44%), infected pancreatic necrosis (5/10, 50%) and death (1/2, 50%)] manifested a substantial increase in their intestinal permeability at D7. Anti-endotoxin antibodies IgG were lower (p = 0.003) in patients than the controls at admission. AEA IgG were lower (p = 0.03) in non-survivors as compared to survivors at D7.
CONCLUSION: Patients experiencing complications of severe acute pancreatitis showed an increase in intestinal permeability. Higher endotoxemia predicted poor outcome in severe acute pancreatitis.
Manik Sharma; Vikas Sachdev; Namrata Singh; Payal Bhardwaj; Anuradha Pal; Suman Kapur; Anoop Saraya
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Tropical gastroenterology : official journal of the Digestive Diseases Foundation     Volume:  33     ISSN:  0250-636X     ISO Abbreviation:  Trop Gastroenterol     Publication Date:    2012 Jan-Mar
Date Detail:
Created Date:  2012-07-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8107122     Medline TA:  Trop Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  45-50     Citation Subset:  IM    
Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi-110029, India.
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